Correlates of Long-Term Survival of Patients with pN+ Esophageal Squamous Cell Carcinoma after Esophagectomy

Abstract

Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of esophageal cancer in China. Patients with ESCC have poor long-term survival, especially those with lymphatic metastasis (pN + ESCC). In this retrospective study, we evaluated the correlates of long-term survival time of patients with pN + ESCC. A total of 453 patients with pN + ESCC who underwent surgical R0 resection between Jan 2008 and Sep 2011 were enrolled. The follow-up ended on December 2019. The clinical, pathological, inflammation-related factors and general survival data of these patients were analyzed using SPSS 22.0 software. The 1-, 3-, and 5-year overall survival (OS) rates were 73.7%, 34.6%, and 25.6%, respectively; the 1-, 3-, and 5-year disease-free survival (DFS) rates were 45.0%, 26.3%, and 20.4%, respectively. The median OS and DFS were 23 and 14 months, respectively. On multivariate analyses, gender, site of lesion, number of dissected lymph nodes, stage pTNM, adjuvant therapy, and neutrophil lymphocyte ratio were independent predictors of OS. Site of lesion, stage pTNM, and adjuvant therapy were independent predictors of DFS. Recursive partitioning analysis (RPA) scores of each patient were calculated based on the independent predictors of OS, and the patients were divided into 3 classes: low-risk, medium-risk, and high-risk. The OS, DFS, and local recurrence-free survival were significantly different among these three RPA classes P < 0.001 . Several factors showed an independent association with long-term postoperative survival of pN + ESCC patients after radical surgery. RPA scores can potentially be used to predict the prognosis of ESCC.

Preoperative Prognostic Nutritional Index Predict Survival in Patients With Resectable Esophageal Squamous Cell Carcinoma

“…Until now, ESCC treatment strategies included surgery, chemotherapy, and radiation ( 11 ). Despite advances in the treatment of ESCC, radical surgical operation remains the modality choice of treatment, but the rate of postoperative recurrence rate is still high ( 12 ). Although tumor, nodes, and metastases (TNM) stage, tumor diameter, and lymph node metastasis can evaluate the prognosis of esophageal cancer, the predictive value is still limited for a long time.…”

The Construction and Development of a Clinical Prediction Model to Assess Lymph Node Metastases in Oesophageal Squamous Carcinoma

“…3 -T 4 ) in 56.7% of the N + group and 32.5% of the N 0 group (P=0.002). However, no signi cant difference was observed in terms of the tumour location and the degree of tumour differentiation between the two groups of patients (P > 0.05).…”

“…The prognosis of ESCC is closely associated with lymph node metastasis, and sreportedly patients with negative lymph node metastasis have a signi cantly higher survival rate than those with positive metastasis [3][4][5][6] . As lymph node metastasis impacts survival and prognosis 7,8 , preoperative lymph node assessment in uences clinical decisions.…”

Outcomes of intravenous and inhalation anesthesia on patients undergoing esophageal cancer surgery: a retrospective observational study

“…Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of EC in China. In contrast, esophageal adenocarcinoma is the predominant type in the Western World [ 3 , 4 ]. The mainstream treatment method is radical resection of esophageal cancer [ 5 ].…”