1. Residual lymph node status is an independent prognostic factor in esophageal squamous cell Carcinoma with pathologic T0 after preoperative radiotherapy
- Author
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Kelin Sun, Lvhua Wang, Ting Xu, Jie He, Zongmei Zhou, Xun Zhang, Shufei Yu, Weibo Yin, Xiao Liu, Zefen Xiao, Qinfu Feng, Qifeng Wang, and Wencheng Zhang
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Disease-Free Survival ,Radiotherapy, High-Energy ,Esophageal squamous cell carcinoma (ESCC) ,Internal medicine ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Lymph node ,Neoadjuvant therapy ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Research ,Radiotherapy Planning, Computer-Assisted ,Neck dissection ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Prognosis ,Primary tumor ,Neoadjuvant Therapy ,Tumor Burden ,Radiation therapy ,Esophagectomy ,medicine.anatomical_structure ,Radiology Nuclear Medicine and imaging ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Neck Dissection ,Female ,Radiotherapy, Intensity-Modulated ,Radiotherapy, Conformal ,business ,Preoperative radiotherapy ,Lymph node metastases ,Radiotherapy, Image-Guided - Abstract
Objective To evaluate the prognostic factors affecting survival in esophageal squamous cell Carcinoma (ESCC) patients with pathologic T0 (ypT0) underwent preoperative radiotherapy. Patients and methods Two hundred and ninety-six patients with ESCC who had received preoperative radiotherapy from 1980 to 2007 were retrospectively analyzed. One hundred patients were ypT0 after preoperative radiotherapy. Univariate and multivariate analyses were performed to evaluate the predictive impact of residual lymph node status on overall survival (OS) and progression-free survival (PFS). Results Among the originally analyzed 296 patients, 100 (33.7 %) patients had ypT0, including 78 patients (78 %) with ypT0N0, and 22 patients (22 %) with ypT0N1. The 5-year OS of the total patients was 42.4 %. Patients with ypT0N0 have significant improved 5-year OS and PFS than ypT0N1 patients (OS: 50.7 % vs 13.6 %, P = 0.004; PFS: 49.6 % vs 13.6 %, P = 0.003). In multivariate analysis, residual lymph node status was also an independent prognostic factors for OS (HR: 0.406, 95 % CI: 0.240–0.686, P = 0.001) and PFS (HR: 0.427, 95 % CI: 0.248–0.734, P = 0.002). Conclusion Our results indicate that patients with ypT0N0 after preoperative radiotherapy had significantly better OS and PFS than patients with ypT0N1 in ESCC. Residual nodal metastasis of ESCC patients with pathological complete response of the primary tumor after neoadjuvant radiotherapy does influence prognosis.
- Published
- 2015