Prognostic value of the extent of lymphadenectomy for esophageal cancer-specific survival among T1 patients

BMC Cancer

Jing Liu-Helmersson¹  Shaowei Sang²  Yang Wang³  Xiufeng Zhang⁴  Wen Xiao⁵  Lin Zhang⁵  Yuanzhu Jiang⁵  Xiangwei Zhang⁵  Keke Liu⁶ 

[1]Centre for Sami Research, Umea University

[2]Clinical Epidemiology Unit, Qilu Hospital of Shandong University

[3]Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University

[4]Department of Respiratory and Critical care, Shandong Public Health Clinical Center

[5]Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University

[6]Shandong Institute of Clinical Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University

关键词: Esophageal cancer;    T1;    Cancer-specific survival;    Prognosis;    Extent of lymphadenectomy;    Cutoff value;   

DOI  :  10.1186/s12885-021-08080-4

来源: DOAJ

【 摘 要 】

Abstract Background Clinically, there are no clear guidelines on the extent of lymphadenectomy in patients with T1 esophageal cancer. Studying the minimum number of lymph nodes for resection may increase cancer-specific survival. Methods Patients who underwent esophagectomy and lymphadenectomy at T1 stage were selected from the Surveillance, Epidemiology and End Results Program (United States, 1998–2014). Maximally selected rank and Cox proportional hazard models were used to examine three variables: the number of lymph nodes examined, the number of negative lymph nodes and the lymph node ratio. Results Approximately 18% had lymph node metastases, where the median values were 10, 10 and 0 for the number of lymph nodes examined, the number of negative lymph nodes and the lymph node ratio, respectively. All three examined variables were statistically associated with cancer-specific survival probability. Dividing patients into two groups shows a clear difference in cancer-specific survival compared to four or five groups for all three variables: there was a 29% decrease in the risk of death with the number of lymph nodes examined ≥14 vs < 14 (hazard ratio 0.71, 95% confidence interval: 0.57–0.89), a 35% decrease in the risk of death with the number of negative lymph nodes ≥13 vs < 13 (hazard ratio 0.65, 95% confidence interval: 0.52–0.81), and an increase of 1.21 times in the risk of death (hazard ratio 2.21, 95% confidence interval: 1.76–2.77) for the lymph node ratio > 0.05 vs ≤ 0.05. Conclusions The extent of lymph node dissection is associated with cancer-specific survival, and the minimum number of lymph nodes that need to be removed is 14. The number of negative lymph nodes and the lymph node ratio also have prognostic value after lymphadenectomy among T1 stage patients.

【 授权许可】

Unknown