Predictive value of postoperative lymph node status for adjuvant therapy in esophageal cancer patients after radical resection
10.3969/j.issn.1000-8179.2020.02.174
- Author:
Chunyang SONG
1
Author Information
1. Department of Radiation Oncology, Fourth Hospital of Hebei Medical University
- Publication Type:Journal Article
- Keywords:
Adjuvant therapy;
Esophageal cancer;
Lymph node status;
Prognosis;
Surgery
- From:
Chinese Journal of Clinical Oncology
2020;47(2):66-71
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the predictive value of postoperative lymph node status for adjuvant therapy in esophageal cancer patients after radical resection. Methods: The indexes related to postoperative lymph node of 354 patients with esophageal carcinoma, who underwent radical surgery during a period between January 2007 and December 2010, were retrospectively analyzed. Univariate analysis was performed by Log-rank test and multivariate analysis by a Cox regression model. Results: The 1-, 3- and 5-year overall survival (OS) rates were 84.46%, 64.12% and 54.06%, respectively, and the median survival time was 86.49 months. The 5-year OS rate of N0, N1, N2 and N3 stage patients were 93.13%, 55.50%, 19.80% and 3.45%, respectively. And it is obviously different from each other in PN stage (χ2=225.161, P<0.001). We used the cut-off value of LNR 8.51% which was obtained by ROC curve to divide the patients into two groups. The 5-year survival rates of the group with LNR≤8.51% and the group with LNR>8.51% were 81.63% and 23.40%, respectively. There were significant differences between the two groups (χ2=143.504, P<0.001). The results of univariate analysis showed that PT stage, PN stage, LNR and number of negative lymph nodes were significantly correlated with OS (all P<0.05). Multivariate analysis showed that the PN stage and LNR were independent factors for OS (all P<0.05). The patients in the PN2 and LNR >8.51% groups with adjuvant therapy showed a significantly better survival than those with surgery alone and without adjuvant therapy (χ2=12.609, P< 0.001; χ2=13.171, P<0.001). The patients in the group with PN2 stage as well as LNR >8.51% who had undergone adjuvant therapy showed a significantly better survival than those with simple surgery and without adjuvant therapy (χ2=12.609, P<0.001). Conclusions: The combination of PN stage and LNR as a better factor for predicting the prognosis of patients with esophageal cancer after radical resection can predict the value of adjuvant therapy. The patients with PN2 stage and higher LNR should choose postoperative adjuvant therapy.
