Division of Thoracic Surgery, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China.
Ann Surg Oncol. 2023 Sep;30(9):5856-5865. doi: 10.1245/s10434-023-13655-5. Epub 2023 May 25.
Esophageal squamous cell carcinoma has a high mortality rate in China. The metastatic pattern in the lymph nodes and the value of their dissection on the overall survival of these patients remain controversial. The primary aim of this study was to provide a basis for accurate staging of esophageal cancer and to identify the relationship between esophageal cancer surgery, lymph node dissection, and overall survival rates.
We utilized our hospital database to retrospectively review the data of 1727 patients with esophageal cancer who underwent R0 esophagectomy from January 2010 to December 2017. The lymph nodes were defined according to Japanese Classification of Esophageal Cancer, 11th Edition. The Efficacy Index (EI) was calculated by multiplying the frequency (%) of metastases to a zone and the 5-year survival rate (%) of patients with metastases to that zone, and then dividing by 100.
The EI was high in the supraclavicular and mediastinal zones in patients with upper esophageal tumors, and the EI of 101R was 17.39, which was the highest among the lymph node stations. In patients with middle esophageal tumors, the EI was highest in the mediastinal zone, followed by the celiac and supraclavicular zones. Furthermore, the EI was highest in the celiac zone, followed by the mediastinal zones in patients with lower esophageal tumors.
The EI of resected lymph nodes was found to vary between stations and was related to the primary location of the tumor.
中国食管癌的死亡率很高。淋巴结的转移模式及其对这些患者总体生存率的影响仍存在争议。本研究的主要目的是为食管癌的准确分期提供依据，并确定食管癌手术、淋巴结清扫与总生存率之间的关系。
我们利用医院数据库回顾性分析了 2010 年 1 月至 2017 年 12 月期间 1727 例接受 R0 食管切除术的食管癌患者的资料。淋巴结根据日本食管癌分类第 11 版定义。通过将转移区域的频率（%）与转移至该区域的患者 5 年生存率（%）相乘，再除以 100，计算出疗效指数（EI）。
在上段食管癌患者中，锁骨上和纵隔区的 EI 较高，101R 淋巴结站的 EI 为 17.39，是所有淋巴结站中最高的。在中段食管癌患者中，纵隔区的 EI 最高，其次是腹腔和锁骨上区。此外，下段食管癌患者中，腹腔区的 EI 最高，其次是纵隔区。
切除淋巴结的 EI 存在于不同的淋巴结站之间，与肿瘤的原发位置有关。
