Ma Mingquan, Tang Peng, Jiang Hongjing, Gong Lei, Duan Xiaofeng, Shang Xiaobin, Yu Zhentao
Department of Esophageal Tumor, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Asia Pac J Clin Oncol. 2017 Oct;13(5):e278-e283. doi: 10.1111/ajco.12567. Epub 2016 Aug 4.
The aim of this study is to investigate the number of negative lymph nodes (NLNs) as a prognostic factor for survival in patients with resected esophageal squamous cell carcinoma.
A total of 381 esophageal squamous cell carcinoma patients who had underwent surgical resection as the primary treatment was enrolled into this retrospective study. The impact of number of NLNs on patient's overall survival was assessed and compared with the factors among the current tumor-nodes-metastasis (TNM) staging system.
The number of NLNs was closely related to the overall survival, and the 5-year survival rate was 45.4% for number of NLNs of >20 (142 cases) and 26.4% for NLNs ≤ 20 (239 cases) (P = 0.001). In multivariate survival analysis, the number of NLNs remained an independent prognostic factor (P = 0.002) as did the other current TNM factors. For subgroup analysis, the predictive value of number of NLNs was significant in patients with T3 or T4 disease (P = 0.001) and patients with N1 and N2-3 disease (P = 0.025, 0.043), but not in patients with T1 or T2 disease or patients with N0 disease.
The number of NLNs, which represents the extent of lymphadenectomy for esophageal squamous cell carcinoma, could impact the overall survival of patients with resected esophageal squamous cell carcinoma, especially among those with nodal-positive disease and advanced T-stage tumor.
本研究旨在调查阴性淋巴结（NLNs）数量作为食管鳞状细胞癌切除患者生存预后因素的情况。
本回顾性研究纳入了381例接受手术切除作为主要治疗的食管鳞状细胞癌患者。评估了NLNs数量对患者总生存的影响，并与当前肿瘤-淋巴结-转移（TNM）分期系统中的因素进行比较。
NLNs数量与总生存密切相关，NLNs数量>20（142例）的患者5年生存率为45.4%，NLNs≤20（239例）的患者为26.4%（P = 0.001）。在多因素生存分析中，NLNs数量与其他当前TNM因素一样，仍然是一个独立的预后因素（P = 0.002）。亚组分析显示，NLNs数量在T3或T4期疾病患者（P = 0.001）以及N1和N2 - 3期疾病患者（P = 0.025，0.043）中具有显著的预测价值，但在T1或T2期疾病患者或N0期疾病患者中则不然。
NLNs数量代表了食管鳞状细胞癌淋巴结清扫的范围，可能影响食管鳞状细胞癌切除患者的总生存，尤其是在淋巴结阳性疾病和T分期较晚的肿瘤患者中。
