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Optimal extent of lymphadenectomy improves prognosis and guides adjuvant chemotherapy in esophageal cancer: A propensity score-matched analysis.
Tang, Ji-Ming; Huang, Shu-Jie; Chen, Qi-Bin; Wu, Han-Sheng; Qiao, Gui-Bin.
Afiliación
  • Tang JM; Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, Guangdong Province, China.
  • Huang SJ; Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, Guangdong Province, China.
  • Chen QB; Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, Guangdong Province, China.
  • Wu HS; Department of Thoracic Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.
  • Qiao GB; Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, Guangdong Province, China. guibinqiao@126.com.
World J Gastrointest Surg ; 16(6): 1537-1547, 2024 Jun 27.
Article en En | MEDLINE | ID: mdl-38983355
ABSTRACT

BACKGROUND:

The optimal extent of lymphadenectomy in esophageal squamous cell carcinoma (ESCC) patients remained debatable.

AIM:

To explore the ideal number of cleared lymph nodes in ESCC patients undergoing upfront surgery.

METHODS:

In this retrospective, propensity score-matched study, we included 1042 ESCC patients who underwent esophagectomy from November 2008 and October 2019. Patients who underwent neoadjuvant therapy were excluded. We collected patients' clinicopathological features and information regarding lymph nodes, including the total number of resected lymph nodes (NRLN), and pathologically diagnosed positive lymph nodes (RPLN). SPSS and R software were used for statistical analysis.

RESULTS:

Among the included 1042 patients, two cohorts ≤ 21 (n = 664) and > 21 NRLN (n = 378) were identified. The final prognostic model included four variables T stage, N, venous thrombus, and the number of removed lymph nodes. Among them, NRLN > 21 was determined as an independent prognosticator after surgery for esophageal cancer (hazards regression = 0.66, 95% confidence interval 0.50-0.87, P = 0.004). A nomogram was created based on the regression coefficients of the variables in the final model. In the training cohort, the predictive model displayed an uncorrected five-year overall survival C-index of 0.659, with a bootstrap-corrected C-index of 0.654. In the subgroup analysis, adjuvant chemotherapy was beneficial in the subgroup with NRLN > 21 and RPLN ≤ 0.16 and NRLN ≤ 21 and RPLN > 0.16.

CONCLUSION:

NRLN > 21 was an independent prognostic factor after ESCC surgery. The combination of NRLN and RPLN may provide a reference for adjuvant chemotherapy use in potential beneficiaries.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Gastrointest Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Gastrointest Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos