He Ming, Qi Zhan, Qiu Rong, Hu Yuanping, Li Juan, Li Yuekao, Wang Yuxiang
Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 50011, China.
Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 50011, China.
J Oncol. 2021 Feb 17;2021:6675691. doi: 10.1155/2021/6675691. eCollection 2021.
Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of esophageal cancer in China. Patients with ESCC have poor long-term survival, especially those with lymphatic metastasis (pN + ESCC). In this retrospective study, we evaluated the correlates of long-term survival time of patients with pN + ESCC. A total of 453 patients with pN + ESCC who underwent surgical R0 resection between Jan 2008 and Sep 2011 were enrolled. The follow-up ended on December 2019. The clinical, pathological, inflammation-related factors and general survival data of these patients were analyzed using SPSS 22.0 software. The 1-, 3-, and 5-year overall survival (OS) rates were 73.7%, 34.6%, and 25.6%, respectively; the 1-, 3-, and 5-year disease-free survival (DFS) rates were 45.0%, 26.3%, and 20.4%, respectively. The median OS and DFS were 23 and 14 months, respectively. On multivariate analyses, gender, site of lesion, number of dissected lymph nodes, stage pTNM, adjuvant therapy, and neutrophil lymphocyte ratio were independent predictors of OS. Site of lesion, stage pTNM, and adjuvant therapy were independent predictors of DFS. Recursive partitioning analysis (RPA) scores of each patient were calculated based on the independent predictors of OS, and the patients were divided into 3 classes: low-risk, medium-risk, and high-risk. The OS, DFS, and local recurrence-free survival were significantly different among these three RPA classes ( < 0.001). Several factors showed an independent association with long-term postoperative survival of pN + ESCC patients after radical surgery. RPA scores can potentially be used to predict the prognosis of ESCC.
食管鳞状细胞癌（ESCC）是中国食管癌最常见的病理类型。ESCC患者长期生存率较低，尤其是那些发生淋巴结转移的患者（pN + ESCC）。在这项回顾性研究中，我们评估了pN + ESCC患者长期生存时间的相关因素。纳入了2008年1月至2011年9月期间接受手术R0切除的453例pN + ESCC患者。随访于2019年12月结束。使用SPSS 22.0软件分析这些患者的临床、病理、炎症相关因素及总体生存数据。1年、3年和5年总生存率（OS）分别为73.7%、34.6%和25.6%；1年、3年和5年无病生存率（DFS）分别为45.0%、26.3%和20.4%。OS和DFS的中位数分别为23个月和14个月。多因素分析显示，性别、病变部位、清扫淋巴结数目、pTNM分期、辅助治疗及中性粒细胞淋巴细胞比值是OS的独立预测因素。病变部位、pTNM分期及辅助治疗是DFS的独立预测因素。根据OS的独立预测因素计算每位患者的递归分区分析（RPA）评分，并将患者分为3类：低风险、中风险和高风险。这三个RPA类别之间的OS、DFS和无局部复发生存率有显著差异（<0.001）。几个因素显示与pN + ESCC患者根治性手术后的长期生存独立相关。RPA评分可能可用于预测ESCC的预后。
