Differences in risk factors of lymph node metastasis between stage T1a and T1b esophageal squamous cell Carcinoma
10.3781/j.issn.1000-7431.2018.33.295
- Author:
Lingdun ZHUGE
1
Author Information
1. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Lymph node excision;
Lymphatic metastasis;
Risk assessment
- From:
Tumor
2018;38(10):951-957
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the differences and similarities of the risk factors (especially lesion size) of lymph node metastasis (LNM) between stage T1a and T1b esophageal squamous cell carcinoma (ESCC), and to further refine the indications of endoscopic radical treatment for early stage esophageal carcinoma. Methods: Retrospective analysis was performed for the patients who received esophagectomy were diagnosed with T1-stage ESCC pathologically in Fudan University Shanghai Cancer Center from January 2010 to December 2016. The clinicopathological characteristics including tumor invasion depth, tumor differentiation degree, tumor size and lymphovascular invasion, as well as follow-up data were collected. Univariate analysis and multivariate Logistic regression analysis were performed to determine the differences in independent risk factors of LNM between T1a and T1b ESCC. Results: Total of 543 patients with T1-stage ESCC were included. Poor differentiation and tumor length larger than 2 cm were independent predictors for LNM in T1b-stage patients (P = 0.002, P = 0.032), but the ones were not related to LNM in T1a-stage patients (P = 0.832, P = 0.133). Lymphovascular invasion was an independent predictor for both T1a- and T1b-stage patients (P = 0.007, P < 0.001), respectively. Survival analysis showed no significant differences in relapse-free survival (RFS) between endoscopic R0 resection and esophagectomy for T1a-stage ESCC patients with tumor length >2 cm (P = 0.140). In T1a- stage ESCC, the tumor invasion of lamina muscularis mucosa (Tm3) was an independent risk factor of LNM (P = 0.031). Conclusion: The risk factors of LNM are different in stage T1a and T1b ESCC patients after endoscopic R0 resection, and which should be treated wisely.
