Fu Xiayu, Liu Qianwen, Luo Kongjia, Wen Jing, Yang Hong, Hu Yi, Wang Xinye, Lin Peng, Fu Jianhua
Department of Thoracic Oncology, Sun Yat-sen University Cancer Centre, Guangzhou, China.
State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Centre of Cancer Medicine, Guangzhou, China.
J Surg Oncol. 2017 Dec;116(7):939-946. doi: 10.1002/jso.24758. Epub 2017 Jul 13.
The objective of this study was to evaluate a revised nodal category based on the value of the lymph node (LN) station ratio (SR, metastatic LN stations/examined LN stations) in esophageal squamous cell carcinoma (ESCC) patients.
Data were obtained from 857 ESCC patients who underwent primary radical esophagectomy. Prognostic performance was evaluated using the Harrell concordance index (C-index), Akaike information criterion (AIC), and likelihood ratio χ test (LR χ test).
Each subgroup among the SR categories demonstrated discriminatory results, whereas no significant survival difference was observed between the N2 versus N3 classifications under the AJCC pN system. Using the AJCC TNM staging system, the survival curves separated between stages IIIA-IIIB and IIIB-IVA. However, when the T-SR-M scheme category was applied, the survival curves between stages IIA-IIB, IIIA-IIIB, and IIIB-IVA were significantly different. Furthermore, both the SR category and the T-SR-M staging system showed superior performance with higher C-index and LR χ test values and lower AIC values compared with the pN category and TNM staging system, respectively.
Following radical esophagectomy, the SR category demonstrated superior prognostic ability relative to the AJCC pN category in ESCC patients.
本研究的目的是基于食管癌鳞状细胞癌（ESCC）患者的淋巴结（LN）站比值（SR，转移淋巴结站数/检查淋巴结站数）评估一种修订的淋巴结分类。
数据来自857例行原发性根治性食管切除术的ESCC患者。使用Harrell一致性指数（C指数）、赤池信息准则（AIC）和似然比χ检验（LR χ检验）评估预后性能。
SR分类中的每个亚组均显示出判别结果，而在AJCC pN系统下，N2与N3分类之间未观察到显著的生存差异。使用AJCC TNM分期系统，生存曲线在IIIA-IIIB期和IIIB-IVA期之间分开。然而，当应用T-SR-M方案分类时，IIA-IIB期、IIIA-IIIB期和IIIB-IVA期之间的生存曲线有显著差异。此外，与pN分类和TNM分期系统相比，SR分类和T-SR-M分期系统均表现出更好的性能，C指数和LR χ检验值更高，AIC值更低。
根治性食管切除术后，SR分类在ESCC患者中显示出相对于AJCC pN分类更好的预后能力。
