Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei City, China.
Thorac Cancer. 2018 Sep;9(9):1129-1135. doi: 10.1111/1759-7714.12796. Epub 2018 Jun 28.
The impact of the number of negative lymph nodes (LNs) on survival in patients with esophageal cancer remains a controversial issue. This study investigated the association between the number of resected LNs and the prognosis of patients with node-negative esophageal carcinoma.
A retrospective review was performed of the data of 429 patients who underwent esophagectomy with modern two-field lymphadenectomy for the treatment of esophageal cancer between January 1998 and December 2008. Histopathology showed no LN involvement in the patient sample. The prognostic impact of the number of negative LNs and the clinicopathological factors were analyzed.
The overall median survival time and the one, three, and five-year overall survival rates were 63.0 months and 78.5%, 64.0%, and 51.2%, respectively. Survival analysis confirmed that the number of negative LNs and the depth of tumor invasion were independent prognostic factors. Patients with a high number of negative LNs had a better overall survival rate than patients with a low number of negative LNs (P < 0.001). Patients with dissected LNs > 14 for pT1 tumors (P < 0.001) and > 19 for pT2-3 tumors (P < 0.001 and P = 0.001, respectively) had better long-term survival outcomes.
The number of negative LNs is an independent prognostic factor for node-negative esophageal carcinoma. Extended LN dissection is recommended to improve the survival of patients with node-negative esophageal carcinoma.
淋巴结阴性（LN）数量对食管癌患者生存的影响仍是一个有争议的问题。本研究旨在探讨食管癌患者 LN 清扫数目与预后的关系。
回顾性分析 1998 年 1 月至 2008 年 12 月期间接受现代两野淋巴结清扫术治疗的 429 例食管癌患者的临床病理资料。所有患者均经病理检查证实无淋巴结转移。分析 LN 清扫数目和临床病理因素与预后的关系。
本组患者中位生存时间为 63.0 个月，1、3、5 年总生存率分别为 78.5%、64.0%、51.2%。生存分析显示，LN 清扫数目和肿瘤侵犯深度是独立的预后因素。LN 清扫数目多的患者总生存率优于 LN 清扫数目少的患者（P<0.001）。对于 T1 期肿瘤，LN 清扫数>14 枚（P<0.001）；对于 T2-3 期肿瘤，LN 清扫数>19 枚（P<0.001 和 P=0.001），患者的长期生存获益更明显。
LN 清扫数目是淋巴结阴性食管癌的独立预后因素。推荐扩大 LN 清扫范围以改善淋巴结阴性食管癌患者的生存。
