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根治性同步放化疗治疗局部晚期食管鳞癌患者锁骨上淋巴结转移的临床影响。

The clinical impact of supraclavicular lymph node metastasis in patients with locally advanced esophageal squamous cell carcinoma receiving curative concurrent chemoradiotherapy.

机构信息

Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

PLoS One. 2018 Jun 11;13(6):e0198800. doi: 10.1371/journal.pone.0198800. eCollection 2018.

Abstract

BACKGROUND

To evaluate the clinical significance of supraclavicular lymph node (SCLN) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) receiving curative concurrent chemoradiotherapy (CCRT).

MATERIALS AND METHODS

We retrospectively analyzed all 369 locally advanced ESCC patients treated with CCRT between 2000 and 2015, including 70 patients with SCLN metastasis and 299 patients without SCLN metastasis.

RESULTS

For these locally advanced ESCC patients treated with curative CCRT, N0-2 were significantly associated with superior progression-free survival (PFS) and overall survival (OS) in univariate and multivariable analyses. However, there were no significant differences in PFS and OS between the SCLN metastasis and non-SCLN metastasis groups; a subgroup analysis also revealed there was no significant differences in PFS and OS between patients with and without SCLN metastasis either in the N0-2 or in the N3 subgroup analysis.

CONCLUSIONS

Our study suggests that SCLN metastasis is not a prognostic factor in locally advanced ESCC patients receiving curative CCRT, and that SCLNs should be considered to be regional LNs and treated with curative intent.

摘要

背景

评估接受根治性同步放化疗(CCRT)的局部晚期食管鳞癌(ESCC)患者锁骨上淋巴结(SCLN)的临床意义。

材料与方法

我们回顾性分析了 2000 年至 2015 年间接受 CCRT 治疗的 369 例局部晚期 ESCC 患者,包括 70 例 SCLN 转移患者和 299 例无 SCLN 转移患者。

结果

对于接受根治性 CCRT 治疗的这些局部晚期 ESCC 患者,N0-2 在单因素和多因素分析中与更好的无进展生存期(PFS)和总生存期(OS)显著相关。然而,SCLN 转移组与非 SCLN 转移组之间的 PFS 和 OS 无显著差异;亚组分析还显示,在 N0-2 或 N3 亚组分析中,无论是否存在 SCLN 转移,PFS 和 OS 均无显著差异。

结论

我们的研究表明,SCLN 转移不是接受根治性 CCRT 的局部晚期 ESCC 患者的预后因素,SCLN 应被视为区域淋巴结并给予根治性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/291b/5995403/4db8c3811b67/pone.0198800.g001.jpg

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