Abstract
BackgroundThere is a controversial relationship between the negative lymph nodes (NLNs) and survival in patients with esophageal squamous cell carcinoma (ESCC). This study investigates the implications of total number of NLNs on thoracic ESCC patient prognosis.Methods579 thoracic ESCC patients were categorized into four groups (0-9, 10-14, 15-19 and ≥20 NLNs). Univariate analysis was done by the log-rank tests while multivariate analysis was undertaken using Cox regression models. Survival analysis was determined employing the Kaplan-Meier method.ResultsWhen the numbers of NLNs were 9 or less, 10 to 14, 15 to 19 and 20 or more, patients of 3-year survival rates were 21.7%, 40.0%, 61.2% and 77.5%, respectively (P<0.001). In the node-negative and node-positive subgroups, 3-year survival rates were 34.9% and 14.3%, 50.9% and 19.3%, 65.6% and 51.8%, 81.4% and 68.9% respectively (P<0.001). Gender, tumor length, tumor differentiation, T and N stage as well as the total NLNs were found to be significantly linked to survival rates. Multivariate analysis showed tumor length, T stage, N stage and total NLNs were independent prognostic factors for ESCC patients.ConclusionNLNs numbers is a significant independent prognostic indicator for thoracic ESCC patients’ survival after curative esophagectomy.
Highlights
Esophageal carcinoma (EC) is a frequently encountered cancer and a major contributor of deaths attributed to cancer worldwide [1]
The total quantity of lymph nodes (LNs) dissected for all patients was 8015 and the total number of negative lymph nodes (NLNs) for the entire cohort was 7366
One of several studies investigating the number of NLNs and its effect on EC patient survival, Zhu et al [18] studied 332 patients with thoracic esophageal squamous cell carcinoma (ESCC) who had at least 15 or more LNs dissected via three-field lymphadenectomy(3FLND) retrospectively and revealed that patients that possessed higher counts of NLNs were more likely to survive longer in contrast to those who had less NLNs
Summary
Esophageal carcinoma (EC) is a frequently encountered cancer and a major contributor of deaths attributed to cancer worldwide [1]. This condition is found at the highest rates in Eastern Asia as well as in Eastern and Southern Africa [1]. The 2 main pathological types of esophageal cancer are adenocarcinoma and squamous cell carcinoma (SCC). Previous literatures have suggested that the total metastatic lymph nodes (LNs) represents an independent prognostic factor in determining EC patients’ survival rates [4, 5]. There is a controversial relationship between the negative lymph nodes (NLNs) and survival in patients with esophageal squamous cell carcinoma (ESCC). This study investigates the implications of total number of NLNs on thoracic ESCC patient prognosis
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