Investigation to metastasis of regional lymph node station and prediction to long-term survival following esophagectomy in thoracic esophageal cancer with stage T1 to T3.

Abstract

e15519 Background: The Lymph node metastasis (LNM) trends toward inferior outcomes for the esophageal cancer (EC) patients after radical operation. However, it is not well known for status to metastasis of regional lymph node (RLN) and impacts of RLN metastasis on long-term survival following esophagectomy, especially in squamous cell carcinoma. Methods: Data was extracted from the Collaborative Prospective Esophageal Cancer Database (designed by LinkDoc Technology Co, Ltd.) for patients with stage T1-3 thoracic tumors who underwent radical esophagectomy between 1 January 2010 and 30 June 2017 across ten hospitals with high volume of surgeries in China. The rate of LNM in every lymph node station was defined as the number of patients with LNM in the station divided by the number of patients with examination of lymph node (ELN) in the station. The hazard ratios (RLN metastasis versus no RLN metastasis) for postoperative survival were analyzed by method of multivariate cox’s proportional hazard models, and confounders such as age, sex, histological grade, stage T, tumor size and neoadjuvant therapy were adjusted. Results: Total 6485 patients (mean age: 61.80±8.13) were included, composing of 75.2% male and 24.8% female. For tumor types, there were 95.5% squamous cell carcinoma, 2% adenocarcinoma and 2.5% others. The rates of RLN metastasis and hazard ratios are in the table. Conclusions: Besides lymph node station 8, LNM was commonly found at station 1,2,4,16,17 and 20 in thoracic stage T1-3 EC. The RLN metastasis predicted inferior postoperative long-term survival. [Table: see text]