Qureshi Sajida, Abbasi Waqas Ahmad, Jalil Hira Abdul, Mughal Saba, Quraishy Muhammad Saeed
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
School of Public Health, Dow University of Health Sciences, Karachi, Pakistan.
Front Oncol. 2025 Jan 17;14:1430876. doi: 10.3389/fonc.2024.1430876. eCollection 2024.
Esophageal cancer (EC) is a significant health concern in South Asia, yet data on prognostic factors, such as lymph node ratio (LNR), in this region is limited. This study aims to assess the prognostic significance of LNR in esophageal squamous cell carcinoma (ESCC) patients undergoing concurrent neoadjuvant therapy followed by minimally invasive esophagectomy (MIE).
This retrospective study analyzed the clinical data of ESCC patients who underwent concurrent neoadjuvant therapy followed by MIE at Dr. Ruth K. M. Pfau Civil Hospital from 2019 to 2023. Lymph node ratios were derived and patients were categorized into three groups: LNR 0, LNR low (≤ 0.1), and LNR high (>0.1). Patient characteristics were compared along with lymph node groups, and survival outcomes were analyzed using the Kruskal Wallis and Chi-square/Fisher exact test, Pearson correlation, Kaplan-Meier (KM) estimates, and Cox regression models.
Among the 47 patients, 15 (31.9%) deaths were observed. Patients with a high LNR had a higher mortality rate (70%) compared to those with a low LNR (41.7%) and 0 LNR (12%) (p = 0.002). Additionally, patients with a high LNR (>0.1) were associated with poorer overall survival (OS) (30.0% vs. 58.3% vs. 88.0%, p < 0.001). A significant correlation was also observed between LNR and the number of metastatic lymph nodes (correlation coefficient = 0.928, p < 0.001).
Our findings demonstrate that high LNR emerged as an independent prognostic factor in ESCC patients undergoing concurrent neoadjuvant therapy followed by MIE.
食管癌（EC）是南亚地区一个重大的健康问题，但该地区关于预后因素的数据，如淋巴结比率（LNR），却很有限。本研究旨在评估LNR在接受同步新辅助治疗后行微创食管切除术（MIE）的食管鳞状细胞癌（ESCC）患者中的预后意义。
这项回顾性研究分析了2019年至2023年在露丝·K·M·普法乌公民医院接受同步新辅助治疗后行MIE的ESCC患者的临床数据。计算出淋巴结比率，并将患者分为三组：LNR为0、LNR低（≤0.1）和LNR高（>0.1）。比较患者特征以及淋巴结分组，并使用Kruskal Wallis检验、卡方检验/费舍尔精确检验、Pearson相关性分析、Kaplan-Meier（KM）估计法和Cox回归模型分析生存结果。
在47例患者中，观察到15例（31.9%）死亡。LNR高的患者死亡率（70%）高于LNR低的患者（41.7%）和LNR为0的患者（12%）（p = 0.002）。此外，LNR高（>0.1）的患者总生存期（OS）较差（分别为30.0%、58.3%和88.0%，p < 0.001）。LNR与转移淋巴结数量之间也存在显著相关性（相关系数 = 0.928，p < 0.001）。
我们的研究结果表明，在接受同步新辅助治疗后行MIE的ESCC患者中，高LNR是一个独立的预后因素。
