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Prognostic value of metastatic lymph nodal ratio in squamous cell carcinoma of esophagus: A three-step extrapolative studySource of Support: Nill.
Background: Transthoracic esophagectomy (TTE) and transhiatal esophagectomy (THE) are the two most common surgical approaches for carcinoma esophagus. Several studies have shown lymph nodal involvement to be one of the most important prognostic factors in carcinoma esophagus. Aims: The primary objective of this study was to explore the effectiveness of the ratio of positive lymph nodes to excised lymph nodes, namely the metastatic lymph nodal ratio (MLNR) as a prognostic factor in the survival of patients with carcinoma esophagus. Settings and Design: Retrospective analysis of a prospective database. Materials and Methods: A review of the operated esophageal cancer patients treated at a tertiary cancer center in South India between January 2002 and December 2006. Statistical analysis was done with the help of SPSS version 17 software (SPSS Inc., Chicago, IL). Proportions were compared using the Chi-square test. Survival data was generated using life table methods. Differences in survival estimates were compared using log-rank test. Results and Conclusions: Our study emphatically showed that the survival outcomes of patients with squamous cell carcinoma of the esophagus can be discriminated based on the MLNR groups, and it can be a reliable prognostic indicator. The overall survival for patients undergoing TTE, or THE for the entire cohort of patients was however not statistically significant. Whether a more aggressive TTE is a better esophageal cancer operation or whether MLNR is the factor that can significantly impact survival regardless of the technique is an issue that would require further investigation.
Key wordsMetastatic lymph nodal ratio - prognosis - transhiatal esophagectomy - transthoracic esophagectomy
Article published online:
31 December 2020
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- 1 Bogoevski D, Onken F, Koenig A, Kaifi JT, Schurr P, Sauter G, et al. Is it time for a new TNM classification in esophageal carcinoma? Ann Surg 2008;247:633-41.
- 2 Dhar DK, Hattori S, Tonomoto Y, Shimoda T, Kato H, Tachibana M, et al. Appraisal of a revised lymph node classification system for esophageal squamous cell cancer. Ann Thorac Surg 2007;83:1265-72.
- 3 Refaely Y, Krasna MJ. Multimodality therapy for esophageal cancer. Surg Clin North Am 2002;82:729-46.
- 4 Hagen JA, DeMeester SR, Peters JH, Chandrasoma P, DeMeester TR. Curative resection for esophageal adenocarcinoma: Analysis of 100 en bloc esophagectomies. Ann Surg 2001;234:520-30.
- 5 Korst RJ, Rusch VW, Venkatraman E, Bains MS, Burt ME, Downey RJ, et al. Proposed revision of the staging classification for esophageal cancer. J Thorac Cardiovasc Surg 1998;115:660-69.
- 6 Nigro JJ, DeMeester SR, Hagen JA, DeMeester TR, Peters JH, Kiyabu M, et al. Node status in transmural esophageal adenocarcinoma and outcome after en bloc esophagectomy. J Thorac Cardiovasc Surg 1999;117:960-8.
- 7 Hu Y, Hu C, Zhang H, Ping Y, Chen LQ. How does the number of resected lymph nodes influence TNM staging and prognosis for esophageal carcinoma? Ann Surg Oncol 2010;17:784-90.
- 8 Peyre CG, Hagen JA, DeMeester SR, Altorki NK, Ancona E, Griffin SM, et al. The number of lymph nodes removed predicts survival in esophageal cancer: An international study on the impact of extent of surgical resection. Ann Surg 2008;248:549-56.
- 9 Greenstein AJ, Litle VR, Swanson SJ, Divino CM, Packer S, Wisnivesky JP. Effect of the number of lymph nodes sampled on postoperative survival of lymph node-negative esophageal cancer. Cancer 2008;112:1239-46.
- 10 Yang HX, Xu Y, Fu JH, Wang JY, Lin P, Rong TH. An evaluation of the number of lymph nodes examined and survival for node-negative esophageal carcinoma: Data from China. Ann Surg Oncol 2010;17:1901-11.
- 11 Fumagalli U, Akiyama H, DeMeester T. Resective surgery for cancer of the thoracic esophagus: Results of a consensus conference held at the VI th World Congress of the International Society for diseases of the esophagus. Dis Esophagus 1996;9:30-8.
- 12 Eloubeidi MA, Desmond R, Arguedas MR, Reed CE, Wilcox CM. Prognostic factors for the survival of patients with esophageal carcinoma in the U.S.: The importance of tumor length and lymph node status. Cancer 2002;95:1434-43.
- 13 Bollschweiler E, Baldus SE, Schröder W, Schneider PM, Hölscher AH. Staging of esophageal carcinoma: Length of tumor and number of involved regional lymph nodes. Are these independent prognostic factors? J Surg Oncol 2006;94:355-63.
- 14 Wilson M, Rosato EL, Chojnacki KA, Chervoneva I, Kairys JC, Cohn HE, et al. Prognostic significance of lymph node metastases and ratio in esophageal cancer. J Surg Res 2008;146:11-5.
- 15 Feng JF, Huang Y, Chen L, Zhao Q. Prognostic analysis of esophageal cancer in elderly patients: Metastatic lymph node ratio versus 2010 AJCC classification by lymph nodes. World J Surg Oncol 2013;11:162.