Residual lymph node status is an independent prognostic factor in esophageal squamous cell Carcinoma with pathologic T0 after preoperative radiotherapy
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.
Qifeng Wang Shufei Yu Zefen Xiao Xiao Liu Wencheng Zhang Xun Zhang Jie He Kelin Sun Ting Xu Qinfu Feng Zongmei Zhou Lvhua Wang Weibo Yin
Department of Radiation Oncology,Cancer Institute and Hospital,Chinese Academy of Medical Sciences,B Department of Radiation Oncology,Cancer Institute and Hospital,Chinese Academy of Medical Sciences,B Department of Pathology,Cancer Institute and Hospital,Chinese Academy of Medical Sciences,Beijing 10 Department of Thoracic Surgery,Cancer Institute and Hospital,Chinese Academy of Medical Sciences,Bei Department of Radiation Oncology,MD Anderson Cancer Center,University of Texas,Houston,Texas,USA