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The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: A 10-Year Experience.
PLoS One. 2015; 10(7):e0133076.Plos

Abstract

BACKGROUND

Lymph node (LN)-related factors including the number of LN regions involved, the LN ratio (LNR), and the number of metastatic LNs are strong prognostic indicators for esophageal squamous cell carcinoma (ESCC) patients. Accurately staging LN involvement may improve the stratification of patients and guide the management of patients.

METHODS

A total of 688 potentially resectable patients who had regional LN metastases were enrolled in this retrospective study.

RESULTS

ESCC involving a single region was associated with better outcomes than that involving multiple regions (P < 0.001 for both PFS and OS). An increased number of metastatic LNs was significantly associated with reduced PFS and OS based on univariate analysis (P < 0.001). PFS and OS were significantly higher in patients with a lower cancer-involved LNR, with 5-year OS rates of 9.7% and 31.4% for patients with a lower and higher cancer-involved LNR, respectively. Based on multivariate analysis, patients with N1 LN involvement experienced longer survival than patients with N2 LN involvement (HR: 1.37; 95% CI: 1.12-1.68) or N3 LN involvement (HR: 1.96; 95% CI: 1.52-2.53). Higher LNR resulted in longer OS than lower LNR based on multivariate analysis (HR: 1.45; 95% CI: 1.15-1.84; P = 0.002).

CONCLUSIONS

Our study has shown that not only the number of metastatic LNs but also the number of involved LN regions predicts outcomes after definitive surgery among Chinese patients with N-positive ESCC. LNR might serve as a powerful indicator that should be included in TNM staging for EC patients.

Authors+Show Affiliations

Department of Medical Oncology, Zhejiang Cancer Hospital, 38 Guangji Road, Hangzhou City, China; Key Laboratory on Diagnosis and Treatment Technology on Thoracic Cancer, Zhejiang Cancer Hospital (Zhejiang Cancer Research Institute), Hangzhou, Zhejiang Province, China.Key Laboratory on Diagnosis and Treatment Technology on Thoracic Cancer, Zhejiang Cancer Hospital (Zhejiang Cancer Research Institute), Hangzhou, Zhejiang Province, China.Department of Radio-Chemotherapy Oncology, Lishui People's Hospital, The Sixth Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.Key Laboratory on Diagnosis and Treatment Technology on Thoracic Cancer, Zhejiang Cancer Hospital (Zhejiang Cancer Research Institute), Hangzhou, Zhejiang Province, China.Key Laboratory on Diagnosis and Treatment Technology on Thoracic Cancer, Zhejiang Cancer Hospital (Zhejiang Cancer Research Institute), Hangzhou, Zhejiang Province, China; Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26177369

Citation

Xu, Xiao-Ling, et al. "The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: a 10-Year Experience." PloS One, vol. 10, no. 7, 2015, pp. e0133076.
Xu XL, Zheng WH, Zhu SM, et al. The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: A 10-Year Experience. PLoS One. 2015;10(7):e0133076.
Xu, X. L., Zheng, W. H., Zhu, S. M., Zhao, A., & Mao, W. M. (2015). The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: A 10-Year Experience. PloS One, 10(7), e0133076. https://doi.org/10.1371/journal.pone.0133076
Xu XL, et al. The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: a 10-Year Experience. PLoS One. 2015;10(7):e0133076. PubMed PMID: 26177369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Prognostic Impact of Lymph Node Involvement in Large Scale Operable Node-Positive Esophageal Squamous Cell Carcinoma Patients: A 10-Year Experience. AU - Xu,Xiao-Ling, AU - Zheng,Wei-Hui, AU - Zhu,Shuang-Mei, AU - Zhao,An, AU - Mao,Wei-Min, Y1 - 2015/07/15/ PY - 2015/04/07/received PY - 2015/06/22/accepted PY - 2015/7/16/entrez PY - 2015/7/16/pubmed PY - 2016/4/23/medline SP - e0133076 EP - e0133076 JF - PloS one JO - PLoS One VL - 10 IS - 7 N2 - BACKGROUND: Lymph node (LN)-related factors including the number of LN regions involved, the LN ratio (LNR), and the number of metastatic LNs are strong prognostic indicators for esophageal squamous cell carcinoma (ESCC) patients. Accurately staging LN involvement may improve the stratification of patients and guide the management of patients. METHODS: A total of 688 potentially resectable patients who had regional LN metastases were enrolled in this retrospective study. RESULTS: ESCC involving a single region was associated with better outcomes than that involving multiple regions (P < 0.001 for both PFS and OS). An increased number of metastatic LNs was significantly associated with reduced PFS and OS based on univariate analysis (P < 0.001). PFS and OS were significantly higher in patients with a lower cancer-involved LNR, with 5-year OS rates of 9.7% and 31.4% for patients with a lower and higher cancer-involved LNR, respectively. Based on multivariate analysis, patients with N1 LN involvement experienced longer survival than patients with N2 LN involvement (HR: 1.37; 95% CI: 1.12-1.68) or N3 LN involvement (HR: 1.96; 95% CI: 1.52-2.53). Higher LNR resulted in longer OS than lower LNR based on multivariate analysis (HR: 1.45; 95% CI: 1.15-1.84; P = 0.002). CONCLUSIONS: Our study has shown that not only the number of metastatic LNs but also the number of involved LN regions predicts outcomes after definitive surgery among Chinese patients with N-positive ESCC. LNR might serve as a powerful indicator that should be included in TNM staging for EC patients. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26177369/The_Prognostic_Impact_of_Lymph_Node_Involvement_in_Large_Scale_Operable_Node_Positive_Esophageal_Squamous_Cell_Carcinoma_Patients:_A_10_Year_Experience_ L2 - https://dx.plos.org/10.1371/journal.pone.0133076 DB - PRIME DP - Unbound Medicine ER -