Relationship between metastatic lymph node and prognosis of esophageal cancer patients treated with following radical esophagectomy

Abstract

Objective: To investigate the number of metastatic lymph nodes (pN) and the metastatic lymph node ratio (LNR) on the post-surgical prognosis of patients with esophageal cancer (EC). Methods: A retrospective analysis of 573 inpatients diagnosed as esophageal carcinomas from March 2008 to June 2012 was carried out.All pathologic specimen were reviewed by pathologists from Henan Tumor Hospital.The Kaplan-Meier method was used to calculate survival rates, and survival curves were compared with the Log-rank test.The Cox model was employed for multivariate analyses of factors.The association of pN and LNR with prognosis of esophageal cancer was examined by the area under the ROC curve(AUC). Results: The 1-, 3- and 5-year OS rates were 72.5%, 46.1% and 32.3%, respectively.Univariate analysis showed that tumor location(P=0.020), tumor length(P=0.009), pT stage(P=0.011), pN stage(P<0.01), and the LNR(P<0.01) were prognostic factors for OS.Multivariate analysis indicated that pT stage(P=0.047), pN stage(P=0.018) and LNR(P=0.011) were significant and independent risk factors for poor OS.ROC analysis indicated that LNR (AUC=0.680) had better predictive value than pN (AUC=0.579). Conclusion: The integrated use of LNR and pN may be suitable for evaluation of prognosis in patients with EC and positive nodal metastasis after curative resection.