Duan Xiaofeng, Yue Jie, Wang Shangren, Zhao Fangdong, Zhang Wencheng, Qie Shuo, Jiang Hongjing
Department of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Department of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tiyuanbei, Huanhuxi Rd., Hexi District, Tianjin, 300060, China.
BMC Cancer. 2025 Jan 10;25(1):61. doi: 10.1186/s12885-025-13465-w.
In this study, we retrospectively examined the prognostic significance of the pathological status of esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (NCRT) and surgery.
Data of patients with cT2-4aN0-3 stage ESCC who underwent NCRT and esophagectomy during 2014-2022 were reviewed retrospectively. Survival differences were compared according to revised TN (rTN) stage (ypT0N0, ypT + N0, ypT0N+, and ypT + N+) using univariate and Cox regression analyses.
Of the 136 patients (59.1 ± 7.2 y) included in this study, 123 (90.4%) were males. There were 39 (28.7%) patients with ypT0N0 disease, 49 (36.0%) ypT + N0, 11 (8.1%) ypT0N+, and 37 (27.2%) ypT + N+. Additionally, 126 patients had a median follow-up period of 30 (1-90) months. The 5-year overall survival was 81.6% in ypT0N0 group, 53.1% for ypT + N0, 50.0% for ypT0N+, and 18.6% for ypT + N+ (p < 0.001) and 5-year disease-free survival was 70.1% for ypT0N0, 39.7% for ypT + N0, 33.3% for ypT0N+, and 18.4% for ypT + N+ (p < 0.001). The ypT + N0 and ypT0N + groups showed no significant differences in survival (p > 0.05). In Cox regression analysis, ypT stage and rTN stage showed an independent association with OS (p = 0.026 and 0.001, respectively). During the follow-up period, 69 (54.8%) patients developed recurrence, with ypT0N0 patients experiencing fewer local and distant recurrences compared to other groups (p < 0.001).
In ESCC patients, the ypT0N0 status after NCRT predicts prolonged survival, but this reduces significantly when nodal metastases or residual primary lesions are present.
在本研究中，我们回顾性研究了新辅助放化疗（NCRT）和手术后食管鳞状细胞癌（ESCC）患者病理状态的预后意义。
回顾性分析2014年至2022年期间接受NCRT和食管切除术的cT2-4aN0-3期ESCC患者的数据。使用单因素和Cox回归分析，根据修订的TN（rTN）分期（ypT0N0、ypT+N0、ypT0N+和ypT+N+）比较生存差异。
本研究纳入的136例患者（59.1±7.2岁）中，123例（90.4%）为男性。ypT0N0期患者39例（28.7%），ypT+N0期49例（36.0%），ypT0N+期11例（8.1%），ypT+N+期37例（27.2%）。此外，126例患者的中位随访期为30（1-90）个月。ypT0N0组5年总生存率为81.6%，ypT+N0组为53.1%，ypT0N+组为50.0%，ypT+N+组为18.6%（p<0.001）；ypT0N0组5年无病生存率为70.1%，ypT+N0组为39.7%，ypT0N+组为33.3%，ypT+N+组为18.4%（p<0.001）。ypT+N0组和ypT0N+组在生存率上无显著差异（p>0.05）。在Cox回归分析中，ypT分期和rTN分期与总生存期独立相关（分别为p=0.026和0.001）。随访期间，69例（54.8%）患者出现复发，ypT0N0患者的局部和远处复发少于其他组（p<0.001）。
在ESCC患者中，NCRT后的ypT0N0状态预示生存期延长，但当出现淋巴结转移或残留原发灶时，生存期会显著缩短。
