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5. The Significance of Negative Lymph Nodes in Esophageal Cancer After Curative Resection: A Retrospective Cohort Study

Author

Mo, Junxian, Chen, Dongni, Li, Changbo, and Chen, Mingwu

Subjects
Cancer Management and Research, esophageal cancer, prognostic factor, Original Research, negative lymph node
Abstract

Junxian Mo,1,2,* Dongni Chen,3,* Changbo Li,2 Mingwu Chen1 1Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China; 2Department of Cardio-Thoracic Surgery, The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou, Guangxi 543000, People’s Republic of China; 3Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mingwu ChenDepartment of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of ChinaEmail chenmingwu535@163.comObjective: The impact of negative lymph nodes (NLNs) count on prognosis in esophageal cancer (EC) was analyzed using two institutions surgical database.Methods: We conducted a retrospective study of 768 EC patients treated by surgical resection between January 2010 and December 2012. The effects of the NLNs count on prognosis was analyzed. Cox regression model was conducted to determine the significant prognostic elements.Results: The number of NLNs was studied as a categorical variable based on the quartiles (Q1: ≤ 15, Q2: 16– 21, Q3: 22– 30, Q4: ≥ 31). And a better overall survival (OS) was observed with increasing number of NLNs (HR= 0.762; 95% CI, 0.596– 0.974 for Q2, HR= 0.666; 95% CI, 0.516– 0.860 for Q3 and HR= 0.588; 95% CI, 0.450– 0.768 for Q4) (all P< 0.05). Multivariate regression analysis revealed that the NLNs count was an independent prognostic factor. Besides, for patients in T2 or T3 stage, a high number of NLNs was found to be significantly associated with a favorable OS (log rank P< 0.001).Conclusion: A higher number of NLNs is independently related to the better OS in EC patients after surgical resection.Keywords: esophageal cancer, negative lymph node, prognostic factor

Published
2020

8. Minimal invasive versus open esophagectomy for patients with esophageal squamous cell carcinoma after neoadjuvant treatments.

Author

Dongni Chen, Weidong Wang, Junxian Mo, Qiannan Ren, Huikai Miao, Youfang Chen, Zhesheng Wen, Chen, Dongni, Wang, Weidong, Mo, Junxian, Ren, Qiannan, Miao, Huikai, Chen, Youfang, and Wen, Zhesheng

Subjects
SQUAMOUS cell carcinoma, ESOPHAGECTOMY, TREATMENT effectiveness, NEOADJUVANT chemotherapy, PROGRESSION-free survival
Abstract

Background: Although previous studies have discussed whether the minimally invasive esophagectomy (MIE) is superior to open surgery, the data concerning esophageal squamous cell carcinoma (ESCC) patients underwent neoadjuvant treatment followed by radical resection is limited. The purpose of our study was to compare the short- and long-term clinical outcomes of the two surgical approaches in treating ESCC patients.Methods: Between January 2010 and December 2016, ESCC patients who had received neoadjuvant therapy and underwent Mckeown esophagectomy at our institute were eligible. The baseline characteristics, pathological data, short-and long-term outcomes of these patients were collected and compared based on the surgical approach.Results: A total of 195 patients was included in the current study. Compared to patients underwent open surgery, patients underwent MIE had shorter operative time and less intraoperative bleeding (390 min vs 330 min, P = 0.001; 204 ml vs 167 ml, P = 0.021). In addition, the risk of anastomotic leakage was decreased in MIE group (20.0% vs 3.3%, P < 0.001), while the occurrence of other complications did not have statistical significance between two groups. Overall survival (OS) and disease-free survival (DFS) was no difference in patients received neoadjuvant chemotherapy between the two approaches. For the patients underwent neoadjuvant chemoradiotherapy, OS was significantly better in the MIE group (log rank = 6.197; P = 0.013).Conclusion: Minimally invasive Mckeown esophagectomy is safe and feasible for ESCC patients who underwent neoadjuvant therapy. MIE approach presented better perioperative results than open esophagectomy. The effect of surgical approaches on survival was depending on the scheme of neoadjuvant treatment. [ABSTRACT FROM AUTHOR]

Published
2021
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