Xi Kexing, Chen Wenyou, Yu Hui
Department of Colorectal Surgery and State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
J Oncol. 2021 Mar 5;2021:8834912. doi: 10.1155/2021/8834912. eCollection 2021.
Early detection and timely treatment are important for improving the prognosis of esophageal cancer (EC). Identification of the prognostic risk factors could help us to discern the high-risk population. This study was aimed at exploring the prognostic significance of log odds of positive lymph nodes (LODDS) in early-stage EC patients.
Patients who underwent esophagectomy and diagnosed as pathologic T1-2 N0 EC were reviewed between January 2005 and December 2015 from the Surveillance, Epidemiology, and End Results (SEER) database (the development cohort, = 1004). The X-tile software was used to determine the optimal cutoff values of LODDS. A separate Chinese cohort including 245 patients (the validation cohort) was used to externally validate the results of the SEER database.
Patients were divided into two groups based on the cutoff points of LODDS: <-1.40 (LODDS1) and ≥-1.40 (LODDS2). In the development cohort, the 5-year overall survival (OS) rate was 75.3% for patients in the LODDS1 group, compared with 67.5% for those in the LODDS2 group (=0.002). In multivariate Cox analysis, LODDS was associated with OS significantly (hazard ratio (HR), 1.48; 95% confidence intervals (CI), 1.19-1.85). In the validation cohort, the 5-year OS rate was 76.6% for patients in the LODDS1 group, compared with 64.4% for those in the LODDS2 group (=0.006). The HR value in multivariate Cox analysis for OS was 2.00 (95% CI, 1.26-3.18).
LODDS was an important independent factor for survival in early-stage EC patients.
早期发现和及时治疗对于改善食管癌（EC）的预后至关重要。识别预后危险因素有助于我们辨别高危人群。本研究旨在探讨早期EC患者阳性淋巴结对数比值（LODDS）的预后意义。
回顾性分析2005年1月至2015年12月期间接受食管切除术并被诊断为病理T1-2 N0 EC的患者，来自监测、流行病学和最终结果（SEER）数据库（开发队列，n = 1004）。使用X-tile软件确定LODDS的最佳截断值。另一个包含245例患者的中国队列（验证队列）用于外部验证SEER数据库的结果。
根据LODDS的截断点将患者分为两组：<-1.40（LODDS1）和≥-1.40（LODDS2）。在开发队列中，LODDS1组患者的5年总生存率（OS）为75.3%，而LODDS2组为67.5%（P = 0.002）。在多变量Cox分析中，LODDS与OS显著相关（风险比（HR），1.48；95%置信区间（CI），1.19 - 1.85）。在验证队列中，LODDS1组患者的5年OS率为76.6%，而LODDS2组为64.4%（P = 0.006）。多变量Cox分析中OS的HR值为2.00（95% CI，1.26 - 3.18）。
LODDS是早期EC患者生存的重要独立因素。
