Fudong Wang1, Xiaosong Ge2, Zhiqiang Wang1, Yuan Weng1, Rong Yin3, Qingjun You1. 1. Department of Thoracic Surgery, The Affiliated Hospital of Jiangnan University, Wuxi 214062, China. 2. Department of Cancer Center, The Affiliated Hospital of Jiangnan University, Wuxi 214062, China. 3. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.
Abstract
BACKGROUND: Although most studies proved that thoracic esophageal cancer surgery with supraclavicular lymph nodes (SCLNs) metastasis could benefit, less than 30% of the 5-year survival rate remained controversy on its surgical treatment. In this study, we aimed to analyze the prognosis of SCLNs on the different segments of thoracic esophageal cancer, which will supply a reference for the treatment of this disease. METHODS: Retrospectively collected the clinical data of 163 patients with thoracic esophageal squamous cancer (ESCC) and compared the effects of SCLNs on prognosis in different segments. RESULTS: Patients with SCLNs metastasis had a worse prognosis than the negative group (P<0.001). In the upper thoracic group, there was no significant difference in OS between SCLNs positive group and negative group (P=0.077); however, in the middle and lower thoracic group, SCLNs positive group had a worse prognosis than the negative group (P<0.001) and lymph nodes positive in other sites (except for SCLNs) (P=0.039). Multivariate analysis found that SCLNs metastasis was an independent risk factor affecting the prognosis of ESCC in the middle and lower thoracic segments (P=0.007). CONCLUSIONS: For patients with upper thoracic ESCC, SCLNs appear to be regional nodes. For the middle and lower thoracic ESCC, SCLNs should be defined as distant metastasis, and neoadjuvant therapy first may be an available therapy. 2020 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Although most studies proved that thoracic esophageal cancer surgery with supraclavicular lymph nodes (SCLNs) metastasis could benefit, less than 30% of the 5-year survival rate remained controversy on its surgical treatment. In this study, we aimed to analyze the prognosis of SCLNs on the different segments of thoracic esophageal cancer, which will supply a reference for the treatment of this disease. METHODS: Retrospectively collected the clinical data of 163 patients with thoracic esophageal squamous cancer (ESCC) and compared the effects of SCLNs on prognosis in different segments. RESULTS: Patients with SCLNs metastasis had a worse prognosis than the negative group (P<0.001). In the upper thoracic group, there was no significant difference in OS between SCLNs positive group and negative group (P=0.077); however, in the middle and lower thoracic group, SCLNs positive group had a worse prognosis than the negative group (P<0.001) and lymph nodes positive in other sites (except for SCLNs) (P=0.039). Multivariate analysis found that SCLNs metastasis was an independent risk factor affecting the prognosis of ESCC in the middle and lower thoracic segments (P=0.007). CONCLUSIONS: For patients with upper thoracic ESCC, SCLNs appear to be regional nodes. For the middle and lower thoracic ESCC, SCLNs should be defined as distant metastasis, and neoadjuvant therapy first may be an available therapy. 2020 Annals of Translational Medicine. All rights reserved.
Authors: Tilak Shah; Vladimir Kushnir; Pritesh Mutha; Mankanchan Majhail; Bhaumik Patel; Matthew Schutzer; Drew Mogahanaki; George Smallfield; Milan Patel; Alvin Zfass Journal: Endosc Int Open Date: 2019-10-31