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Prognostic significance of lymph node characteristics on survival in esophageal squamous cell carcinomas

Prognostische Bedeutung von Lymphknoten-Charakteristika für das Überleben beim Plattenepithelkarzinom des Ösophagus

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Summary

Objectives

To investigate the prognostic significance of lymph node characteristics (total number of resected lymph nodes, metastatic lymph node ratio, and metastatic lymph nodes site) on survival in patients with esophageal squamous cell carcinoma.

Methods

Patients who underwent esophagectomy at Huashan Hospital, Fudan University, between October 1, 2003, and December 31, 2008, were reviewed. Survival data and clinicopathological characteristics were collected.

Results

Among 205 patients, the median overall survival time was 48.0 months and the overall 5-year survival rate was 44.7 %. The independent risk factors for disease-free survival were the metastatic lymph node ratio (P < 0.001) and the number of positive lymph nodes (P < 0.001) and not the total number of resected lymph nodes (Χ 2 = 3.063, P = 0.216). There was no difference in survival between patients with extrathoracic and intrathoracic lymph node metastasis (Χ 2 = 0.295, P = 0.587). No significant relation was found between tumor location and the site of metastatic lymph nodes (rs = 0.125, P = 0.245).

Conclusions

Our finding revealed that the ratio and the number, but not the site, of metastatic lymph nodes were independent prognostic risk factors in esophageal squamous cell carcinomas. We suggest taking these factors into consideration for better estimation of prognosis.

Zusammenfassung

Ziel

Untersuchung der prognostischen Bedeutung der Lymphknoten-Charakteristika (Quotient der Gesamtzahl der resezierten Lymphknoten zu den metastasierten Lymphknoten, Lokalisation der Lymphknoten) auf das Überleben von Patienten mit einem Plattenepithelkarzinom des Ösophagus.

Methodik

Es wurden die Überlebensraten und klinisch-pathologischen Charakteristika von Patienten, die von 1.10.2003 bis 31.12.2008 am Huashan Spital der Fudan Universität ösophagektomiert wurden, gesammelt und ausgewertet.

Ergebnisse

Die mediane Gesamtüberlebenszeit der 205 Patientenbetrug 48 Monate. Die Gesamt 5-Jahre Überlebensrate lag bei 44,7 %. Die Gesamtzahl der resezierten Lymphknoten war kein unabhängiger Risikofaktor (Χ 2 = 3,063; P = 0,216). Unabhängige Risikofaktoren waren der Quotient der metastasierten Lymphknoten (P < 0,001) und die Zahl der positiven Lymphknoten (P < 0,001). Es bestand kein Unterschied in den Überlebensraten der Patienten mit intrathorakalen Lymphknotenmetastasen im Vergleich zu denen mit extrathorakalen Lymphknotenmetastasen (Χ 2 = 0,295; P = 0,587). Es wurde keine signifikante Korrelation zwischen der Tumorlokalisation und der Lokalisation der Lymphknotenmetastasen gefunden (rs = 0,125; P = 0,245).

Schlussfolgerungen

Unsere Ergebnisse zeigen, dass der Quotient und die Zahl, nicht aber die Lage der befallenen Lymphknoten unabhängige Risikofaktoren beim Plattenepithelkarzinom des Ösohagus sind. Wir empfehlen daher, diese Faktoren zur besseren Prognoseabschätzung in Erwägung zu ziehen.

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The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, 200040, Shanghai, P.R. China

    Ning Wu MD, Zhiming Chen MD, Liewen Pang MD, Qinyun Ma & Gang Chen

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  1. Ning Wu MD
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  2. Zhiming Chen MD
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  3. Liewen Pang MD
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  4. Qinyun Ma
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  5. Gang Chen
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Correspondence to Zhiming Chen MD.

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Wu, N., Chen, Z., Pang, L. et al. Prognostic significance of lymph node characteristics on survival in esophageal squamous cell carcinomas. Wien Klin Wochenschr 125, 26–33 (2013). https://doi.org/10.1007/s00508-012-0310-2

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  • DOI: https://doi.org/10.1007/s00508-012-0310-2

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