Wang L, Cai L, Chen Q, Jiang Y H
Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Zhonghua Zhong Liu Za Zhi. 2017 Oct 23;39(10):749-753. doi: 10.3760/cma.j.issn.0253-3766.2017.10.006.
To evaluate the prognostic value of three different staging schemes based on positive lymph nodes (pN), metastatic lymph nodes ratio (MLR) and log odds of positive lymph nodes (LODDS) in patients with T3 esophageal cancer. From 2007 to 2014, clinicopathological characteristics of 905 patients who were pathologically diagnosed as T3 esophageal cancer and underwent radical esophagectomy in Zhejiang Cancer Hospital were retrospectively analyzed. Kaplan-Meier curves and Multivariate Cox proportional hazards models were used to evaluate the independent prognostic factors. The values of three lymph node staging schemes for predicting 5-year survival were analyzed by using receiver operating characteristic (ROC) curves. The 1-, 3- and 5-year overall survival rates of patients with T3 esophageal cancer were 80.9%, 50.0% and 38.4%, respectively. Multivariate analysis showed that MLR stage, LODDS stage and differentiation were independent prognostic survival factors (<0.05 for all). ROC curves showed that the area under the curve of pN stage, MLR stage, LODDS stage was 0.607, 0.613 and 0.618, respectively. However, the differences were not statistically significant (>0.05). LODDS is an independent prognostic factor for patients with T3 esophageal cancer. The value of LODDS staging system may be superior to pN staging system for evaluating the prognosis of these patients.
评估基于阳性淋巴结(pN)、转移淋巴结比率(MLR)和阳性淋巴结对数优势比(LODDS)的三种不同分期方案对T3期食管癌患者的预后价值。回顾性分析2007年至2014年在浙江省肿瘤医院接受根治性食管切除术且病理诊断为T3期食管癌的905例患者的临床病理特征。采用Kaplan-Meier曲线和多变量Cox比例风险模型评估独立预后因素。利用受试者工作特征(ROC)曲线分析三种淋巴结分期方案预测5年生存率的值。T3期食管癌患者的1年、3年和5年总生存率分别为80.9%、50.0%和38.4%。多变量分析显示,MLR分期、LODDS分期和分化程度是独立的预后生存因素(均P<0.05)。ROC曲线显示,pN分期、MLR分期、LODDS分期的曲线下面积分别为0.607、0.613和0.618。然而,差异无统计学意义(P>0.05)。LODDS是T3期食管癌患者的独立预后因素。在评估这些患者的预后方面,LODDS分期系统的价值可能优于pN分期系统。