Retrospective analysis of predictive factors for lymph node metastasis in superficial esophageal squamous cell carcinoma

Ruan, Rongwei; Chen, Shengsen; Tao, Yunxia; Yu, Jiangping; Zhou, Danping; Zhao, Chun‐Mei; Shen, Qiwen; Wang, Shi

doi:10.1038/s41598-021-96088-y

Cited by 14 publications

(13 citation statements)

References 34 publications

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“…Our study also found that lesion size > 20 mm, submucosal invasion, and LVI were independent risk factors for LNM, which is consistent with the findings of Ruan et al, [32] Jiang et al [33] and Xu et al [34] Taking the tumor size ≤ 20 mm as a reference, the odds ratio of tumor size > 20 mm was 6.956 (95% CI 1.244–38.913) for predicting LNM, indicating that the lesion size is an important risk factor for LNM. The reason for the large 95% confidence interval may be the small size of the data; however, it still showed that there was a strong relevance between lesion size and LNM.…”

Section: Discussionsupporting

confidence: 93%

A practical nomogram included hyperlipidemia for predicting lymph node metastasis in patients with superficial esophageal squamous cell carcinoma

Wang,

Liu,

Mao

et al. 2023

Medicine

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To select an optimal treatment, it is crucial to evaluate the risk of lymph node metastasis (LNM) in patients with superficial esophageal squamous cell carcinoma (SESCC). The research aimed to explore more risk factors than before and construct a practical nomogram to predict LNM in patients with SESCC. We retrospectively reviewed 1080 patients diagnosed with esophageal cancer who underwent esophagectomy with lymphadenectomy between January 2013 and October 2021 at the Affiliated Hospital of Qingdao University. The clinical parameters, endoscopic features, and pathological characteristics of the 123 patients that were finally enrolled in this study were collected. The independent risk factors for LNM were determined using univariate and multivariate analyses. Using these factors, a nomogram was constructed to predict LNM. LNM was observed in 21 patients. Univariate analysis showed that the absence or presence of hypertriglyceridemia, tumor location, lesion size, macroscopic type, invasion depth, differentiation, absence or presence of lymphovascular invasion (LVI), and perineural invasion were significantly associated with LNM. According to the multivariate analysis, hypertriglyceridemia, tumors located in the lower thoracic esophagus, lesion size > 20 mm, submucosal invasion, and LVI were independent risk factors for LNM. A nomogram was established using these 5 factors. It showed good calibration and discrimination. Hypertriglyceridemia, tumors located in the lower thoracic esophagus, lesion size > 20 mm, submucosal invasion, and LVI were independent risk factors for LNM. A nomogram was constructed using these 5 factors. This model can help clinicians assess the risk of LNM in patients with SESCC for optimal treatment selection.

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Section: Discussionsupporting

confidence: 93%

A practical nomogram included hyperlipidemia for predicting lymph node metastasis in patients with superficial esophageal squamous cell carcinoma

Wang,

Liu,

Mao

et al. 2023

Medicine

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“…For example, a retrospective analysis in patients with esophageal squamous cell carcinoma found that tumor size, depth of tumor invasion, degree of tumor differentiation, and lymphovascular invasion were significantly predictors of lymph node metastasis (LNM). 46 These findings were consistent with the present results, which suggested that patients with well-differentiated pathology on the nomogram had lower scores and a better prognosis. Therefore, the early pathological diagnosis of esophageal cancer patients is important in evaluating patient prognosis.…”

Section: Discussionsupporting

confidence: 93%

Effects of Radiotherapy on Survival of Esophageal Cancer Patients Receiving Immunotherapy: Propensity Score Analysis and Nomogram Construction

Nie¹,

Yao²,

Li³

et al. 2022

CMAR

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Purpose The present study assessed the effects of radiotherapy on overall survival (OS) and progression-free survival time (PFS) in patients with stage II or higher esophageal cancer receiving immunotherapy; evaluated factors independently prognostic of OS and PFS in these patients; and utilized these factors to establish a prognostic nomogram. Patients and Methods This study enrolled 134 patients with stage II or higher esophageal cancer treated with chemotherapy (platinum-based agents plus paclitaxel or fluorouracil) and immunotherapy. These patients were divided into two groups, a radiotherapy (RT) group (n = 55) and a non-radiotherapy (non-RT) group (n = 79). Following 1:1 propensity score matching, OS and PFS were compared by the Kaplan–Meier method, and factors associated with survival were determined by univariate and multifactorial Cox regression analyses. These factors were used to construct a prognostic nomogram. Results After propensity matching, all covariates were well balanced in the two groups (all P > 0.05). After matching, both median PFS (15.70 months [95% confidence interval (CI) 8.68–22.72 months] vs 5.70 months [95% CI 3.38–8.02 months], P = 0.002) and median OS (15.72 months [95% CI 12.94–18.46 months] vs 12.06 months [95% CI 9.91–14.20 months], P = 0.036) were significantly longer in the RT than in the non-RT group. Univariate and multifactorial analyses showed that RT, neutrophil-lymphocyte ratios, and tumor differentiation were independently prognostic of OS, with all hazard ratios (HRs) <1 and all P-values <0.05. A nomogram based on these factors was constructed, and its accuracy was verified. Conclusion Immunotherapy plus RT resulted in better survival outcomes than immunotherapy alone. A nomogram based on prognostic factors can guide personalized treatment and monitor prognosis.

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“…It is worth noting that 15.71% (22/140) of patients had angiolymphatic invasions. Previous studies have demonstrated that angiolymphatic invasion is closely correlated with lymph node metastasis [ 30 , 31 , 32 , 33 ]. A relevant study showed that angiolymphatic invasion may occur even in stage T1a SESCN, with an incidence of approximately 3.12% [ 34 ], which was close to our results (4.29%).…”

Section: Discussionmentioning

confidence: 99%

The Feasibility and Safety of Endoscopic Submucosal Dissection for Circumferential Superficial Esophageal Squamous Cell Neoplasms

Liu

Dou

Rao

et al. 2023

JCM

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Background It remains controversial whether endoscopic submucosal dissection (ESD) is still appropriate for circumferential superficial esophageal squamous cell neoplasms (SESCN), and few studies compared the short-term and long-term outcomes of ESD with radical surgery. Methods A total of 140 patients with SESCN who underwent ESD or surgery between February 2014 and October 2021 were retrospectively reviewed. The characteristics of patients, operative time, postoperative complications, overall survival (OS), recurrence-free survival (RFS), and quality of life (QOL) were compared between the ESD and surgery groups. The effect of different methods to prevent esophageal stenosis after ESD were analysed. Results Drinking, family history of cancer, macroscopic type, and intrapapillary capillary loop (IPCL) type were independent risk factors for deep submucosal invasion (SM ≥ 200 μm). Smoking and IPCL type were independent predictive factors for angiolymphatic invasion. The average operative time of ESD was significantly shorter than that of surgery (174.5 ± 51.16 min vs. 255.9 ± 88.18 min, p < 0.001). The incidence of perioperative complications in ESD group was significantly lower than that in surgery group (5.5% vs. 19.4%, p = 0.015). The ESD group had significantly better functional scale scores for emotional functioning, cognitive functioning, and global health status, and lower rates of pain, dyspnoea, insomnia, appetite loss, diarrhoea, reflux, and trouble with taste than the surgery group. No significant difference in OS and RFS between ESD and surgery group. Conclusions ESD can significantly shorten the operative time and reduce perioperative complications. Additionally, on the premise of using appropriate measures to prevent postoperative stenosis, ESD can be the first choice for the treatment of SESCN, which could provide better QOL, and the long-term prognosis of ESD is no less than that of surgery.

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Retrospective analysis of predictive factors for lymph node metastasis in superficial esophageal squamous cell carcinoma

Cited by 14 publications

References 34 publications

A practical nomogram included hyperlipidemia for predicting lymph node metastasis in patients with superficial esophageal squamous cell carcinoma

A practical nomogram included hyperlipidemia for predicting lymph node metastasis in patients with superficial esophageal squamous cell carcinoma

Effects of Radiotherapy on Survival of Esophageal Cancer Patients Receiving Immunotherapy: Propensity Score Analysis and Nomogram Construction

The Feasibility and Safety of Endoscopic Submucosal Dissection for Circumferential Superficial Esophageal Squamous Cell Neoplasms

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