Abstract
BackgroundNumerous studies have addressed lymphovascular invasion (LVI) in patients with thoracic oesophageal squamous cell carcinoma (ESCC); however, little is known about the individual roles of lymphatic invasion (LI) and vascular invasion (VI). We aimed to analyse the prognostic significance of LI and VI in patients with thoracic ESCC from a single centre.MethodsThis retrospective study included 396 patients with thoracic ESCC who underwent oesophagectomy and lymphadenectomy in our hospital. The relationship between LI, VI and the other clinical features was analysed, and disease-free survival (DFS) was calculated. Survival analysis was performed by univariate and multivariate statistics.ResultsBriefly, VI and LI were present in 25.8% (102 of 396) and 23.7% (94 of 396) of ESCC patients, respectively, with 9.15% patients presenting both LI and VI; the remaining patients did not present LI or VI. We found that LI was significantly associated with pN stage (P<0.001) and pTNM stage (P<0.001), and similar results were found in VI. Moreover, survival analysis showed that pT stage (P<0.001), pN stage (P=0.001), pTNM stage (p<0.001), VI (P=0.001) and LI (P<0.001) were associated with DFS in ESCC. Furthermore, multivariate analysis suggested that pT stage (RR=1.4, P =0.032), pN stage (RR=1.9, P<0.001) and LI (RR=1.5, P=0.008) were independent predictive factors for DFS. Finally, relapse was observed in 110 patients (lymph node metastasis, 78 and distant, 32) and 147 patients with cancer-related deaths. Subanalysis showed that LI-positive patients had higher lymph node metastasis, although there was no significant difference (32.1% vs. 15.6%, P=0.100).ConclusionsLI and VI were common in ESCC; they were all survival predictors for patients with ESCC, and LI was independent. Patients with positive LI were more likely to suffer lymph node metastasis.
Highlights
Worldwide, oesophageal cancer is the seventh most widespread cancer and constitutes the sixth leading cause of cancer death, accounting for 5.3% of all global cancer deaths [1]
vascular invasion (VI) was present in 25.8% of patients (102 of 396), and lymphatic invasion (LI) was present in 23.7% of patients (94 of 396)
VI was significantly associated with pT stage (P=0.013), pN stage (P
Summary
Oesophageal cancer is the seventh most widespread cancer and constitutes the sixth leading cause of cancer death, accounting for 5.3% of all global cancer deaths [1]. The staging guidelines of the American Joint Cancer Committee on Cancer mandated distinguishing lymphatic and vascular invasion (LI vs VI) as early as 2005, these guidelines lack a routine standard and objective assessment method to reliably differentiate them [12]. Previous studies focused on LI and VI together in patients with thoracic oesophageal squamous cell carcinoma (ESCC); the data on the individual role of LI and VI were limited. The aim of the present study was to analyse the individual influence of LI and VI on the prognosis of ESCC. Numerous studies have addressed lymphovascular invasion (LVI) in patients with thoracic oesophageal squamous cell carcinoma (ESCC); little is known about the individual roles of lymphatic invasion (LI) and vascular invasion (VI). We aimed to analyse the prognostic significance of LI and VI in patients with thoracic ESCC from a single centre
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