Abstract
BackgroundThe aims of this study were to determine the recurrence rate and the prognostic factors for recurrence-free survival (RFS) in esophageal squamous cell carcinoma (ESCC) patients without lymph node metastasis (LNM).MethodsBetween January 2011 and June 2017, 101 patients with ESCC were treated and pathologically confirmed to be lymph node negative. The clinicopathological parameters were evaluated to identify the prognostic factors for RFS using Cox proportional hazards models.ResultsNineteen out of 101 patients (18.8%) developed recurrence, and the median RFS was 41 months. The most common pattern of relapse was local recurrence (n = 11; 57.9%), followed by distant recurrence (n = 7; 36.8%); one patient developed local and distant recurrence simultaneously. The results of multivariate analysis showed that the independent prognostic factors for decreased RFS in node-negative patients were a tumor located in the upper chest (odds ratio [OR], 0.767; 95% confidence intervals (CI), 1.523–14.916, P = 0.007), the presence of lymphovascular invasion (OR, 3.534; 95% CI, 1.077–11.596, P = 0.037), and a preoperative serum carcinoembryonic antigen level ≥ 5 μg/ml (OR = 5.466; 95% CI, 1.590–18.787, P = 0.007).ConclusionsThe aforementioned parameters were the prognostic factors in node-negative ESCC patients, and they associated with a higher probability of recurrence after surgery. These patients should be followed closely, and adjuvant therapy should be considered.
Highlights
The aims of this study were to determine the recurrence rate and the prognostic factors for recurrence-free survival (RFS) in esophageal squamous cell carcinoma (ESCC) patients without lymph node metastasis (LNM)
The following were excluded: (1) patients with a pathological type of nonsquamous cell carcinoma; (2) patients with pathologically confirmed LNM; (3) patients with tumors that had a positive margin (R1 or R2); (4) patients who received neoadjuvant or adjuvant chemotherapy or chemoradiotherapy; (5) patients who died of non-neoplastic causes; and (6) patients who were lost during follow-up
The following were excluded: (1) patients with a pathological type of nonsquamous cell carcinoma (n = 8); (2) patients with pathologically confirmed LNM (n = 147); (3) patients with tumors that had a positive margin (R1 or R2) (n = 1); (4) patients who received neoadjuvant or adjuvant chemotherapy or chemoradiotherapy (n = 34); (5) patients who died of non-neoplastic diseases (n = 8); and (6) patients who were lost during follow-up (n = 2)
Summary
The aims of this study were to determine the recurrence rate and the prognostic factors for recurrence-free survival (RFS) in esophageal squamous cell carcinoma (ESCC) patients without lymph node metastasis (LNM). Esophageal squamous cell carcinoma (ESCC) is a common malignant tumor occurring in Chinese individuals [1]. It is necessary to identify other clinicopathological parameters that could be used as prognostic indicators in these node-negative patients. We evaluated the recurrence rate and analyzed the prognostic factors for recurrence-free survival (RFS) in node-negative patients at a single institution. Our findings are likely to provide a reference point for clinicians to better assess the degree of tumor malignancy and to influence the use of adjuvant treatment in node-negative patients
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