Abstract
BackgroundAlthough the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC.MethodsThis study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status.ResultsLNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P < 0.001).ConclusionsThis study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).
Highlights
Esophageal cancer (EC) is one of the most common cancers worldwide, with an estimated 604,100 new cases occurring globally in 2020
Lymph node metastasis (LNM) was shown to be an accurate predictor of disease-free survival that can identify patients who may require adjuvant chemotherapy or chemoradiotherapy for the treatment of systemic metastases occurring after primary resection [19, 20]
After adjusting for age, tumor length, vascular tumor thrombus, N stage, T stage, and treatment, we found that LNM along the left gastric artery (P = 0.011, hazard ratios (HR) = 1. 920) was an independent prognostic factor in patients with esophageal squamous cell carcinoma (ESCC)
Summary
Esophageal cancer (EC) is one of the most common cancers worldwide, with an estimated 604,100 new cases occurring globally in 2020. It is the sixth most common cause of death from cancer [1]. Lymph node (LN) metastasis (LNM) is one of the single most important prognostic factors in EC [3]. The incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported.
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