Abstract
BackgroundTo evaluate the clinical outcomes of celiac lymph node (LN) metastasis in patients with locally advanced esophageal squamous cell carcinoma (ESCC) receiving curative concurrent chemoradiotherapy (CCRT).Materials and MethodsA total of 375 stage III ESCC patients were identified, including 51 patients with celiac LN metastasis and 324 patients without celiac LN metastasis. Among these 324 patients without celiac LN metastasis, 51 were matched with the 51 patients with celiac LN metastasis using the propensity score matching method.ResultsOverall, the celiac LN metastasis group had worse progression-free survival (PFS) and overall survival (OS) than the non-celiac LN metastasis group and the matched non-celiac LN metastasis group. For the ESCC patients with celiac LN metastasis, lower third ESCC was significantly associated with superior PFS and OS. For patients with upper/middle third ESCC, the celiac LN metastasis group had worse PFS and OS than the non-celiac LN metastasis group and the matched non-celiac LN metastasis group. For patients with lower third ESCC, there were no significant differences in PFS and OS between these groups.ConclusionsOur study suggests celiac LN metastasis is a poor prognostic factor for locally advanced ESCC patients receiving curative CCRT. Among these ESCC patients with celiac LN metastasis, tumor location is a strongly prognostic factor, indicating patients with lower third ESCC have better PFS and OS than those with upper/middle third ESCC. The 6th American Joint Committee on Cancer staging system seems more favorable than 7th edition in the definition of celiac LNs for those patients.
Highlights
Esophageal squamous cell carcinoma (ESCC) is an aggressive disease with an increasing incidence worldwide, and is the ninth leading cause of cancer deaths in Taiwan [1]
The 6th American Joint Committee on Cancer staging system seems more favorable than 7th edition in the definition of celiac lymph node (LN) for those patients
We retrospectively reviewed our esophageal squamous cell carcinoma (ESCC) database, and 375 locally advanced stage III ESCC patients who received curative concurrent chemoradiotherapy (CCRT) were identified, including 51 ESCC with celiac LN metastasis
Summary
Esophageal squamous cell carcinoma (ESCC) is an aggressive disease with an increasing incidence worldwide, and is the ninth leading cause of cancer deaths in Taiwan [1]. The majority of ESCC patients have locally advanced disease when they are diagnosed, and more than half of patients with locally advanced disease are clinically unresectable. For those patients who are unresectable, concurrent chemoradiotherapy (CCRT) is one of the standard therapies. To evaluate the clinical outcomes of celiac lymph node (LN) metastasis in patients with locally advanced esophageal squamous cell carcinoma (ESCC) receiving curative concurrent chemoradiotherapy (CCRT)
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