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Tumor Biology

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01.04.2015 | Research Article

Prognostic significance of lymph node ratio in esophageal cancer

verfasst von: Nana Wang, Yibin Jia, Jianbo Wang, Xintong Wang, Cihang Bao, Qingxu Song, Bingxu Tan, Yufeng Cheng

Erschienen in: Tumor Biology | Ausgabe 4/2015

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Abstract

N staging predicting esophageal cancer patient prognosis has been studied. Lymph node ratio, which is considered to show metastatic lymph node status more accurately, is found to have prognostic significance in several tumors. We investigated whether lymph node ratio (LNR) was associated with the prognosis of esophageal cancer in this study. Esophageal cancer patients who underwent esophagectomy at Qilu Hospital of Shandong University from January 2007 to December 2008 were studied. A total of 209 cases were evaluated in this study. The median disease-free survival (DFS) of this cohort was 35.2 months, and 5-year DFS rate was 32.1 %. The median overall survival (OS) was 46.4 months, and 5-year OS rate was 40.0 %. Kaplan–Meier survival analysis revealed that patients with LNR higher than 0.2 had significantly poorer DFS (p < 0.001) and OS (p < 0.001) than those with LNR less than 0.2. In a multivariate analysis, LNR was found to be an independent prognostic factor for DFS (p = 0.008, HR 1.863, 95 % CI 1.180–2.942) and OS (p = 0.025, HR 1.708, 95 % CI 1.068–2.731). N stage (p = 0.028, HR 1.626, 95 % CI 1.055–2.506) was also found to be an independent prognostic factors for OS. Subgroups analysis revealed significant difference in OS and DFS rates between different LNR categories within the same N stages (p < 0.05) but not between different N stages within the same LNR category (p > 0.05). LNR was recognized as an independent factor in both OS and DFS in esophageal cancer. Besides, LNR showed a better prognostic value than N stage for esophageal cancer.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA: Cancer J Clin. 2013;63(1):11–30. doi:10.3322/caac.21166.

Dubecz A, Gall I, Solymosi N, Schweigert M, Peters JH, Feith M, et al. Temporal trends in long-term survival and cure rates in esophageal cancer: a SEER database analysis. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2012;7(2):443–7. doi:10.1097/JTO.0b013e3182397751.CrossRef

Lee PC, Port JL, Paul S, Stiles BM, Altorki NK. Predictors of long-term survival after resection of esophageal carcinoma with nonregional nodal metastases. Ann Thorac Surg. 2009;88(1):186–92. doi:10.1016/j.athoracsur.2009.03.079. discussion 92–3.CrossRefPubMed

Peyre CG, Hagen JA, DeMeester SR, Van Lanschot JJ, Holscher A, Law S, et al. Predicting systemic disease in patients with esophageal cancer after esophagectomy: a multinational study on the significance of the number of involved lymph nodes. Ann Surg. 2008;248(6):979–85. doi:10.1097/SLA.0b013e3181904f3c.CrossRefPubMed

Rizk N, Venkatraman E, Park B, Flores R, Bains MS, Rusch V, et al. The prognostic importance of the number of involved lymph nodes in esophageal cancer: implications for revisions of the American Joint Committee on Cancer staging system. J Thorac Cardiovasc Surg. 2006;132(6):1374–81. doi:10.1016/j.jtcvs.2006.07.039.CrossRefPubMed

Chen SB, Weng HR, Wang G, Yang JS, Yang WP, Liu DT, et al. Prognostic factors and outcome for patients with esophageal squamous cell carcinoma underwent surgical resection alone: evaluation of the seventh edition of the American Joint Committee on Cancer staging system for esophageal squamous cell carcinoma. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2013;8(4):495–501. doi:10.1097/JTO.0b013e3182829e2c.CrossRef

Zhu Z, Chen H, Yu W, Fu X, Xiang J, Li H, et al. Number of negative lymph nodes is associated with survival in thoracic esophageal squamous cell carcinoma patients undergoing three-field lymphadenectomy. Ann Surg Oncol. 2014;21(9):2857–63. doi:10.1245/s10434-014-3665-y.CrossRefPubMed

Chang GJ, Rodriguez-Bigas MA, Skibber JM, Moyer VA. Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst. 2007;99(6):433–41. doi:10.1093/jnci/djk092.CrossRefPubMed

Gorog D, Nagy P, Peter A, Perner F. Influence of obesity on lymph node recovery from rectal resection specimens. Pathol Oncol Res: POR. 2003;9(3):180–3.CrossRefPubMed

10.

Fujita H. The history of lymphadenectomy for esophageal cancer and the future prospects for esophageal cancer surgery. Surg Today. 2014. doi:10.1007/s00595-014-0841-4.

11.

Sisic L, Blank S, Weichert W, Jager D, Springfeld C, Hochreiter M, et al. Prognostic impact of lymph node involvement and the extent of lymphadenectomy (LAD) in adenocarcinoma of the esophagogastric junction (AEG). Langenbeck’s Arch Surg/Deut Ges Chir. 2013;398(7):973–81. doi:10.1007/s00423-013-1101-6.CrossRef

12.

Lee YC, Yang PJ, Zhong Y, Clancy TE, Lin MT, Wang J. Lymph node ratio-based staging system outperforms the seventh AJCC system for gastric cancer: validation analysis with National Taiwan University Hospital Cancer Registry. Am J Clin Oncol. 2014. doi:10.1097/COC.0000000000000110.PubMedCentral

13.

Shida A, Fujioka S, Kawamura M, Takahashi N, Ishibashi Y, Nakada K, et al. Prediction of lymph node metastasis in patients with submucosa-invading early gastric cancer. Anticancer Res. 2014;34(8):4471–4.PubMed

14.

Park J, Byun BH, Noh WC, Lee SS, Kim HA, Kim EK, et al. Lymph node to primary tumor SUV ratio by 18F-FDG PET/CT and the prediction of axillary lymph node metastases in breast cancer. Clin Nucl Med. 2014;39(4):e249–53. doi:10.1097/RLU.0b013e3182a75477.CrossRefPubMed

15.

Jiang K, Zhu Y, Liu Y, Ye Y, Xie Q, Yang X, et al. Lymph node ratio as an independent prognostic indicator in stage III colorectal cancer: especially for fewer than 12 lymph nodes examined. Tumour Biol: J Int Soc Oncodev Biol Med. 2014. doi:10.1007/s13277-014-2484-x.

16.

Chen SL, Steele SR, Eberhardt J, Zhu K, Bilchik A, Stojadinovic A. Lymph node ratio as a quality and prognostic indicator in stage III colon cancer. Ann Surg. 2011;253(1):82–7. doi:10.1097/SLA.0b013e3181ffa780.CrossRefPubMed

17.

Bollschweiler E, Baldus SE, Schroder W, Schneider PM, Holscher AH. Staging of esophageal carcinoma: length of tumor and number of involved regional lymph nodes. Are these independent prognostic factors? J Surg Oncol. 2006;94(5):355–63. doi:10.1002/jso.20569.CrossRefPubMed

18.

Talsma K, van Hagen P, Grotenhuis BA, Steyerberg EW, Tilanus HW, van Lanschot JJ, et al. Comparison of the 6th and 7th Editions of the UICC-AJCC TNM Classification for Esophageal Cancer. Ann Surg Oncol. 2012;19(7):2142–8. doi:10.1245/s10434-012-2218-5.CrossRefPubMedPubMedCentral

19.

Lorenzon L, Mercantini P, Ferri M, La Torre M, Sparagna A, Balducci G, et al. Lymph-node ratio classification strongly correlates with cancer survivals of patients who underwent R0 resection for gastric cancer with more than 15 nodes harvested. Eur Surg Res Europaische Chir Forsch Rech Chir Europeennes. 2014;53(1–4):1–10. doi:10.1159/000360937.

20.

Ke B, Song XN, Liu N, Zhang RP, Wang CL, Liang H. Prognostic value of the lymph node ratio in stage III gastric cancer patients undergoing radical resection. PLoS One. 2014;9(5):e96455. doi:10.1371/journal.pone.0096455.CrossRefPubMedPubMedCentral

21.

Birnbaum DJ, Vigano L, Russolillo N, Langella S, Ferrero A, Capussotti L. Lymph node metastases in patients undergoing surgery for a gallbladder cancer. Extension of the lymph node dissection and prognostic value of the lymph node ratio. Ann Surg Oncol. 2014. doi:10.1245/s10434-014-4044-4.

22.

Smith BJ, Mezhir JJ. An interactive Bayesian model for prediction of lymph node ratio and survival in pancreatic cancer patients. J Am Med Inf Assoc: JAMIA. 2014;21(e2):e203–11. doi:10.1136/amiajnl-2013-002171.CrossRef

23.

Chen YL, Wang CY, Wu CC, Lee MS, Hung SK, Chen WC, et al. Prognostic influences of lymph node ratio in major cancers of Taiwan: a longitudinal study from a single cancer center. J Cancer Res Clin Oncol. 2014. doi:10.1007/s00432-014-1810-4.

24.

Greenstein AJ, Litle VR, Swanson SJ, Divino CM, Packer S, Wisnivesky JP. Prognostic significance of the number of lymph node metastases in esophageal cancer. J Am Coll Surg. 2008;206(2):239–46. doi:10.1016/j.jamcollsurg.2007.09.003.CrossRefPubMed

25.

Kelty CJ, Kennedy CW, Falk GL. Ratio of metastatic lymph nodes to total number of nodes resected is prognostic for survival in esophageal carcinoma. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2010;5(9):1467–71.CrossRef

26.

Tan Z, Ma G, Yang H, Zhang L, Rong T, Lin P. Can lymph node ratio replace pN categories in the tumor-node-metastasis classification system for esophageal cancer? J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2014;9(8):1214–21. doi:10.1097/JTO.0000000000000216.CrossRef

27.

Tepper J, Krasna MJ, Niedzwiecki D, Hollis D, Reed CE, Goldberg R, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol: Off J Am Soc Clin Oncol. 2008;26(7):1086–92. doi:10.1200/JCO.2007.12.9593.CrossRef

28.

Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74. doi:10.1245/s10434-011-2049-9.CrossRefPubMed

29.

Mariette C, Piessen G, Briez N, Triboulet JP. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg. 2008;247(2):365–71. doi:10.1097/SLA.0b013e31815aaadf.CrossRefPubMed

30.

D’Journo XB, Doddoli C, Michelet P, Loundou A, Trousse D, Giudicelli R, et al. Transthoracic esophagectomy for adenocarcinoma of the oesophagus: standard versus extended two-field mediastinal lymphadenectomy? Eur J Cardio-Thorac Surg: Off J Eur Assoc Cardio-Thorac Surg. 2005;27(4):697–704. doi:10.1016/j.ejcts.2004.12.022.CrossRef

31.

Chandarana M, Jiwnani S, Karimundackal G, Pramesh CS. Lymphadenectomy in esophageal cancer: the real issues. Ann Thorac Surg. 2014;98(1):389–90. doi:10.1016/j.athoracsur.2014.01.040.CrossRefPubMed

32.

Davies AR, Sandhu H, Pillai A, Sinha P, Mattsson F, Forshaw MJ, et al. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg. 2014;101(5):511–7. doi:10.1002/bjs.9456.CrossRefPubMed

33.

Ye T, Sun Y, Zhang Y, Zhang Y, Chen H. Three-field or two-field resection for thoracic esophageal cancer: a meta-analysis. Ann Thorac Surg. 2013;96(6):1933–41. doi:10.1016/j.athoracsur.2013.06.050.CrossRefPubMed

Titel: Prognostic significance of lymph node ratio in esophageal cancer
verfasst von: Nana Wang
Yibin Jia
Jianbo Wang
Xintong Wang
Cihang Bao
Qingxu Song
Bingxu Tan
Yufeng Cheng
Publikationsdatum: 01.04.2015
Verlag: Springer Netherlands
Erschienen in: Tumor Biology / Ausgabe 4/2015
Print ISSN: 1010-4283
Elektronische ISSN: 1423-0380
DOI: https://doi.org/10.1007/s13277-014-2840-x

Springer Medizin

Prognostic significance of lymph node ratio in esophageal cancer

Abstract

Neu im Fachgebiet Onkologie

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Springer Medizin

Abstract

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