Prognostic significance and role of thoracic lymph node metastasis based on Chinese expert consensus in esophageal cancer

Shang, Qi‐Xin; Yang, Yu‐Shang; Hu, Weipeng; Yuan, Yong; Ji, Ai‐Fang; Chen, Long Qi

doi:10.21037/atm.2019.07.63

Cited by 12 publications

(14 citation statements)

References 30 publications

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“…Esophageal cancer (EC) is the seventh most common cancer, and the sixth cancer-related cause of death throughout the world (1). In contrast to adenocarcinoma as the primary histological subtype in Western countries, squamous cell carcinoma accounts for about 90% of EC and ranks as the sixth most common cancer and the fourth leading cause of cancer-related deaths in China (2). Although advances in surgical techniques and therapeutic options during the past decade, ESCC is still characterized by its poor outcome, with a 5-year survival rate of around 25% in China (3,4).…”

Section: Introductionmentioning

confidence: 99%

RACGAP1 is transcriptionally regulated by E2F3, and its depletion leads to mitotic catastrophe in esophageal squamous cell carcinoma

Zhao¹,

Wang²,

Wang³

et al. 2020

Ann Transl Med

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Background: RACGAP1 has significant involvement in tumorigenesis of cancers, including liver cancer, stomach cancer, and colon cancer. However, the role and the exact mechanism of RACGAP1 in esophageal squamous cell carcinoma (ESCC) has not been explored.Methods: QPCR and Western blots analysis was performed to analyze the expression of RACGAP1 in ESCC. MTT assays and colony formation assays were performed to explore the functional role of RACGAP1 in ESCC. Cell cycle analysis and immunofluorescence assays were used to investigate the function of RACGAP1 involvement in mitotic catastrophe. At last, we conducted the public datasets mining to explore the expression status and prognosis value of RACGAP1 as well as the correlation between RACGAP1 and E2F3 in various cancers. Results:The high abnormal expression of RACGAP1 is observed in ESCC and associated with worse clinical outcomes of patients with ESCC. RACGAP1, a novel cell cycle associated gene regulated by E2F3, acts as an oncogenic driver in ESCC cell lines. Notably, for the first time, RACGAP1 depletion induced severe mitotic catastrophe, followed by massive cell death.Conclusions: Our findings showed the essential role of RACGAP1 in ESCC cancer cell survival and the therapeutic potential of RACGAP1 as a molecular target for ESCC.

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Section: Introductionmentioning

confidence: 99%

RACGAP1 is transcriptionally regulated by E2F3, and its depletion leads to mitotic catastrophe in esophageal squamous cell carcinoma

Zhao¹,

Wang²,

Wang³

et al. 2020

Ann Transl Med

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“…An accurate staging system and individualized prognosis prediction could help clinicians to identify patients with poor prognoses 9 correctly; this is essential for ensuring such patients receive a multi-disciplinary treatment regimen to improve the curative effects of treatment on EC. Existing research has identified specific factors that directly influence the occurrence and progress of EC, including the preoperative C-reactive protein/albumin ratio, 10 neutrophil-to-lymphocyte ratio, 11 and thoracic lymph node metastasis, 12 among other factors. [13][14][15][16][17][18] However, currently, there are no methods that can accurately predict postoperative prognosis in patients with stage T1-3N0M0 ESCC.…”

Section: Introductionmentioning

confidence: 99%

Establishment and validation of a prognostic risk classification for patients with stage T1-3N0M0 esophageal squamous cell carcinoma

Huang

Zheng

Liang

et al. 2021

Preprint

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Background: No existing methods can accurately predict postoperative prognosis in patients with stage T1-3N0M0 esophageal squamous cell carcinoma (ESCC). We explored the postoperative prognosis of such patients using a new prognostic risk classification system (Esorisk). Methods: Patients with stage T1-3N0M0 ESCC from two cancer centers—Sun Yat-sen University Cancer Center (training cohort: N=819) and Henan Cancer Hospital (external validation cohort: N=177)—who underwent esophagectomy between 1995 and 2015 were included. We integrated significant risk factors for death events into multivariable logistic regression models and applied them to the training cohort to build Esorisk. The parsimonious aggregate Esorisk score was calculated for each patient; the training set was divided into three prognostic risk classes according to the 33rd and 66th Esorisk score percentiles. Esorisk’s association with cancer-specific survival (CSS) was assessed using Cox proportional hazard regression analyses. Results: The Esorisk model was: [10 + 0.023 × age + 0.517 × drinking history – 0.012 × hemoglobin – 0.042 × albumin – 0.032 × lymph nodes removed]. Patients were grouped into three classes—Class A (5.14-7.26, low risk), Class B (7.27-7.70, middle risk), and Class C (7.71-9.29, high risk). In the training group, the 5-year CSS decreased across categories (A: 63%, B: 52%, C: 30%; log-rank P<0.001). Similar findings were observed in the validation group (A: 81%, B: 69%, C: 48%; log-rank P<0.001). Esorisk stratified the CSS in patients from two cohorts with stage pT1 (P=0.0029), pT2 (P<0.001), or pT3 (P<0.001) disease. Cox proportional hazard regression analyses showed that the Esorisk aggregate score remained significantly associated with CSS in the training cohort (P<0.001) and validation cohort (P=0.001) after adjusting for pT stage and tumor differentiation. Conclusion: We established and validated a novel prognostic risk classification that can predict the CSS for patients with T1-3N0M0 ESCC. This may help clinicians identify patient subgroups with poor prognosis.

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“…Lymph node (LN) metastasis has been reported as a signi cant prognostic factor in the patients with thoracic esophageal squamous cell carcinoma (ESCC) [1]. Cancer cells of the thoracic ESCC could spread widely to the cervical and abdominal lymph nodes besides mediastinal lymph nodes through rich longitudinal lymphoid vessels in the submucosa of the esophagus, and this usually leads to poor prognosis [2].…”

Section: Introductionmentioning

confidence: 99%

Characteristics And Prognostic Value of Lymph Node Metastasis Along Recurrent Laryngeal Nerves in Thoracic Esophageal Squamous Cell Carcinoma

Yuan

Gao

et al. 2021

Preprint

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Background: Though the value of lymph node (LN) dissection along bilateral recurrent laryngeal nerve (RLN) has been debated and emphasized in recent years in thoracic esophageal squamous cell carcinoma (ESCC). However, the characteristics of nodal metastasis along RLN chain has not been clarified. This study aimed to investigate the characteristics of nodal metastasis along recurrent laryngeal nerves and the influence of these metastasis on the prognosis of thoracic ESCC.Patients and Methods: 339 eligible patients with thoracic ESCC who underwent esophagectomy with a three-field(3-FL) or two-field(2-FL) lymph node dissection from March 2015 to December 2018 were included in this study, consisting of 282 males and 57 females with a mean age of 60.6 years (range,40-80 years). The association of LN metastasis near RLN with clinicopathologic factors and its influence on survival were analyzed. Results: Among the 339 patients, 96 (28.3%) had LN metastasis along bilateral recurrent laryngeal nerves, 76 (22.4%) with positive LNs along right RLN and 47 (13.9%) along the left RLN. There was a significant difference in the metastasis rate between the LNs along right RLN and along the left RLN (P=0.004). The LN metastasis rate along RLN was significantly correlated with primary tumor locations (upper vs middle vs lower: 35.1% vs 30.9% vs 15.6%; P=0.015), tumor invasion depth (T3/T4 vs T1 vs T2: 36.2% vs 15.8% vs 26.2%, P=0.001 ) and degree of differentiation (well vs moderately vs poorly: 9.3% vs 29.3% vs 33.9%; P=0.009), subcarinal and left tracheobronchial lymph node metastasis (positive vs negative:58.1% vs 25.3%, P＜0.001), abdominal LN metastasis (positive vs negative:41.2% vs 24.0%, P=0.003 ), but was not significantly correlated with age, gender and tumor length. The median follow-up time for this study was 34 months. The cumulative 1-, 2- and 3-year overall survival rates were 95.7%, 86.6% and 82.2% in RLN-LN(-) group versus 81.5%, 67.4% and 53.7% in the RLN-LN(+) group, with a significant difference between two group (HR=2.975,95% CI:1.918-4.614, P＜0.01). Conclusions: The lymph node metastasis along RLNs was significantly correlated with primary tumor locations, tumor invasion depth, tumor differentiation, metastasis in the LNs of other stations, and indicate poor prognosis in ESCC.

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Prognostic significance and role of thoracic lymph node metastasis based on Chinese expert consensus in esophageal cancer

Cited by 12 publications

References 30 publications

RACGAP1 is transcriptionally regulated by E2F3, and its depletion leads to mitotic catastrophe in esophageal squamous cell carcinoma

RACGAP1 is transcriptionally regulated by E2F3, and its depletion leads to mitotic catastrophe in esophageal squamous cell carcinoma

Establishment and validation of a prognostic risk classification for patients with stage T1-3N0M0 esophageal squamous cell carcinoma

Characteristics And Prognostic Value of Lymph Node Metastasis Along Recurrent Laryngeal Nerves in Thoracic Esophageal Squamous Cell Carcinoma

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