Prognostic impact of sterilized lymph nodes in esophageal squamous cell carcinomas after neoadjuvant chemoradiotherapy |
| |
| Institution: | 1. Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands;2. Department of Cardiothoracic Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands;3. Department of pulmonary diseases, Amsterdam University Medical Center, Amsterdam, The Netherlands;4. Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands;5. Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands;6. Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands;7. Department of Surgery, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands;1. Surgical Outcomes Research Centre (SOuRCe), University of Sydney & Sydney Local Health District, New South Wales, Australia;2. Data Analysis Surgical Outcomes Unit (DASO), Royal North Shore Hospital, Sydney, New South Wales, Australia;3. The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, New South Wales, Australia;4. The Institute of Academic Surgery at RPA, Sydney Local Health District, Sydney, New South Wales, Australia;5. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia;1. Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy;2. Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy;3. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;4. Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;5. Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;6. Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;1. Section of Gastrointestinal Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain;2. Service of Surgery, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain;3. Service of Surgery, Hospital Universitari de Bellvitge, L''Hospitalet de Llobregat, Barcelona, Spain;4. Service of Surgery, Hospital Universitari Vall d''Hebron, Barcelona, Spain;5. Service of Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain;6. Service of Surgery, Hospital Universitari Arnau de Vilanova, Lleida, Spain;7. Service of Surgery, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain;8. Service of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain;9. Service of Surgery, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain;10. Service of Surgery, Hospital Universitari Parc Taulí de Sabadell, Sabadell, Barcelona, Spain;11. Service of Gastrointestinal Surgery, Hospital Clinic, Barcelona, Spain;12. Service of Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;13. Service of Surgery, Hospital General de Granollers, Granollers, Barcelona, Spain;14. Service of Surgery, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain;15. Service of Surgery, Hospital Universitari de Vic, Vic, Barcelona, Spain;p. Service of Surgery, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain;q. Service of Surgery, Hospital Universitari Sant Joan de Reus, Reus, Spain;r. Service of Surgery, Hospital de Sant Joan de Deu de Manresa, Manresa, Spain;s. Service of Surgery, Hospital Universitari de Igualada, Igualada, Spain;1. Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, 1 Avenue Magellan, 33604, Pessac, CHU Bordeaux, France;2. Département de Chirurgie Rachidienne, Hôpital Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, CHU Bordeaux, France;3. Département de Chirurgie Vasculaire, Hôpital Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, CHU Bordeaux, France;4. Département D''imagerie Diagnostique et Interventionnelle, Hôpital Haut-Lévèque, 1 Avenue Magellan, 33604, Pessac, CHU Bordeaux, France;5. Département D''urologie, Hôpital Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, CHU Bordeaux, France |
| |
| Abstract: | BackgroundThe prognostic importance of sterilized lymph nodes (SLN) remains unclear in patients with esophageal squamous cell carcinomas (ESCC) treated by neoadjuvant chemoradiotherapy (nCRT). This study aimed to determine whether SLN predicted disease-free survival (DFS) in ESCC.MethodsWe enrolled 246 eligible patients who were divided into SLN (+) and SLN (-) group according to the presence or absence of fibrosis, necrosis, calcifications and/or foreign body giant cell reactions in the negative lymph nodes specimens. The prognostic value of SLN was determined using univariate and multivariate analyses. The prognostic strength of counting SLN as positive lymph nodes was evaluated using the difference of Akaike information criterion (ΔAIC).ResultsA total of 61 SLN were identified in 38 (15.4%) patients. There was no significant difference in baseline characteristics between SLN (+) and SLN (-) group. The most frequently detected SLN in the thoracic cavity and abdominal cavity were those along bilateral recurrent laryngeal nerve (21/38,55.3%) and left gastric artery (13/24,60.9%), respectively. The univariate and multivariate analyses showed SLN was an independent prognostic factor for worse DFS in the whole cohort (HR = 2.05, 95%CI = 1.08–3.90, P = 0.029). The SLN (+) group additionally correlated with worse 5-year DFS than SLN (-) group in the ypT0, ypN0 and pCR subgroups. Counting SLN as positive lymph nodes showed better prognostic strength than ignoring them.ConclusionSLN was of prognostic significance for worse DFS in patients with ESCC, particularly in patients with good response to nCRT. |
| |
| Keywords: | Esophageal squamous cell carcinomas Neoadjuvant chemoradiotherapy Sterilized lymph nodes Prognostic value |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
