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Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival.
Dig Dis Sci. 2015 Sep; 60(9):2771-6.DD

Abstract

BACKGROUND

The prognostic value of metastatic lymph node ratio (LNR) is still controversial in esophageal cancer.

AIM

This study aimed to compare the impact of AJCC N staging system (pN) and LNR on the prediction of long-term survival of patients with esophageal carcinoma.

METHODS

A total of 496 patients were retrospectively analyzed who underwent esophageal resection at Henan Tumor Hospital from January 2006 to December 2010. The Kaplan-Meier method and log-rank test were used to estimate survival curves. Univariate and multivariate analyses were performed to compare prognostic factors for long-term survival. The difference between pN and LNR with overall survival (OS) was compared by receiver operating characteristic (ROC) curve and area under the curve (AUC).

RESULTS

The 1-, 3-, 5-year overall survival rates of 496 patients were 73.6, 47.1 and 34.2 %, respectively. Univariate analyses showed that diseased region, tumor length, depth of tumor invasion, pN and LNR affected the prognosis, and multivariate analyses demonstrated that depth of tumor invasion, pN and LNR were independent risk factors. Among the three significant variables verified by multivariate analyses, LNR was the best for inadequately staged patients (<12 examined LNs). ROC analyses showed that compared with pN (AUC = 0.579, p = 0.037), LNR (AUC = 0.680, p = 0.002) had better predictive value (z = 2.275, p = 0.029).

CONCLUSIONS

LNR has greater prognostic value than pN for esophageal squamous cell carcinoma, especially for patients with <12 LNs removed.

Authors+Show Affiliations

Department of Internal Medicine-Oncology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, No. 127, Dongming Road, Zhengzhou, 450000, Henan Province, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25939544

Citation

Wei, Chen, et al. "Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival." Digestive Diseases and Sciences, vol. 60, no. 9, 2015, pp. 2771-6.
Wei C, Deng WY, Li N, et al. Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival. Dig Dis Sci. 2015;60(9):2771-6.
Wei, C., Deng, W. Y., Li, N., Shen, W., Zhang, C., Liu, J. Y., & Luo, S. X. (2015). Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival. Digestive Diseases and Sciences, 60(9), 2771-6. https://doi.org/10.1007/s10620-015-3681-1
Wei C, et al. Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival. Dig Dis Sci. 2015;60(9):2771-6. PubMed PMID: 25939544.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymph Node Ratio as an Alternative to the Number of Metastatic Lymph Nodes for the Prediction of Esophageal Carcinoma Patient Survival. AU - Wei,Chen, AU - Deng,Wen-Ying, AU - Li,Ning, AU - Shen,Wei, AU - Zhang,Chi, AU - Liu,Jia-Yu, AU - Luo,Su-Xia, Y1 - 2015/05/05/ PY - 2015/01/09/received PY - 2015/04/20/accepted PY - 2015/5/6/entrez PY - 2015/5/6/pubmed PY - 2015/11/11/medline SP - 2771 EP - 6 JF - Digestive diseases and sciences JO - Dig Dis Sci VL - 60 IS - 9 N2 - BACKGROUND: The prognostic value of metastatic lymph node ratio (LNR) is still controversial in esophageal cancer. AIM: This study aimed to compare the impact of AJCC N staging system (pN) and LNR on the prediction of long-term survival of patients with esophageal carcinoma. METHODS: A total of 496 patients were retrospectively analyzed who underwent esophageal resection at Henan Tumor Hospital from January 2006 to December 2010. The Kaplan-Meier method and log-rank test were used to estimate survival curves. Univariate and multivariate analyses were performed to compare prognostic factors for long-term survival. The difference between pN and LNR with overall survival (OS) was compared by receiver operating characteristic (ROC) curve and area under the curve (AUC). RESULTS: The 1-, 3-, 5-year overall survival rates of 496 patients were 73.6, 47.1 and 34.2 %, respectively. Univariate analyses showed that diseased region, tumor length, depth of tumor invasion, pN and LNR affected the prognosis, and multivariate analyses demonstrated that depth of tumor invasion, pN and LNR were independent risk factors. Among the three significant variables verified by multivariate analyses, LNR was the best for inadequately staged patients (<12 examined LNs). ROC analyses showed that compared with pN (AUC = 0.579, p = 0.037), LNR (AUC = 0.680, p = 0.002) had better predictive value (z = 2.275, p = 0.029). CONCLUSIONS: LNR has greater prognostic value than pN for esophageal squamous cell carcinoma, especially for patients with <12 LNs removed. SN - 1573-2568 UR - https://www.unboundmedicine.com/medline/citation/25939544/Lymph_Node_Ratio_as_an_Alternative_to_the_Number_of_Metastatic_Lymph_Nodes_for_the_Prediction_of_Esophageal_Carcinoma_Patient_Survival_ L2 - https://doi.org/10.1007/s10620-015-3681-1 DB - PRIME DP - Unbound Medicine ER -