清扫的淋巴结数目是接受根治性食管切除术且淋巴结转移阴性患者的独立预后因素。
The Number of Harvested LNs Is an Independent Prognostic Factor in Lymph Node Metastasis-negative Patients Who Received Curative Esophagectomy.
机构信息
Department of Surgery, Yokohama City University, Yokohama, Japan
Department of Surgery, Yokohama City University, Yokohama, Japan.
出版信息
In Vivo. 2020 Jul-Aug;34(4):2021-2027. doi: 10.21873/invivo.12001.
BACKGROUND/AIM: The aim of the present study was to evaluate the optimal number of harvested LNs (LNs) in patients who were LN metastasis-negative after curative esophagectomy for esophageal cancer.
PATIENTS AND METHODS
Sixty-one patients who underwent curative surgery for esophageal cancer between 2005 and 2017 and diagnosed as lymph node metastasis-negative were included in this study.
RESULTS
The 5-year overall survival rates were 27.8% for 0-20 harvested LNs, 35.7% for 21-30 harvested LNs, 79.4% for 31-40 harvested LNs, and 85.2% for ≥41 harvested LNs. Thirty harvested LNs was regarded as the optimal critical point of classification, considering the 5-year OS rate. The number of harvested LNs was selected as a significant prognostic factor in both univariate and multivariate analyses. The respective 3- and 5-year OS rates were 50.3% and 36.7% for <30 harvested LNs and 82.4% and 82.4% for ≥30 harvested LNs (p=0.003).
CONCLUSION
Thirty or more harvested LNs was a significant prognostic factor in patients with metastasis-negative LNs after curative esophagectomy for esophageal cancer. Therefore, the number of harvested LNs might be useful for predicting the LN metastasis status in esophageal cancer.
背景/目的：本研究旨在评估在根治性食管癌手术后淋巴结转移阴性的患者中，最佳的淋巴结（LNs）检出数量。
方法
本研究纳入了 2005 年至 2017 年间接受根治性食管癌手术且诊断为淋巴结转移阴性的 61 例患者。
结果
0-20 个淋巴结检出组、21-30 个淋巴结检出组、31-40 个淋巴结检出组和≥41 个淋巴结检出组的 5 年总生存率分别为 27.8%、35.7%、79.4%和 85.2%。考虑到 5 年 OS 率，30 个淋巴结检出被视为分类的最佳临界点。在单因素和多因素分析中，淋巴结检出数量均被选为显著的预后因素。<30 个淋巴结检出组的 3 年和 5 年 OS 率分别为 50.3%和 36.7%，≥30 个淋巴结检出组的 3 年和 5 年 OS 率分别为 82.4%和 82.4%（p=0.003）。
结论
对于根治性食管癌手术后淋巴结转移阴性的患者，检出 30 个或更多的淋巴结是一个显著的预后因素。因此，淋巴结检出数量可能有助于预测食管癌的淋巴结转移状态。
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