Risk prediction of occult lymph node metastasis in patients with clinical T1 through T2 N0 esophageal squamous cell carcinoma

医学 接收机工作特性 食管癌 内科学 淋巴结 神秘的 肿瘤科 转移 放射科 胃肠病学 食管鳞状细胞癌 癌症 阶段(地层学) 病理 古生物学 替代医学 生物
作者
Jae Kwang Yun,Hyeong Ryul Kim,Seung Il Park,Yong‐Hee Kim
出处
期刊:The Journal of Thoracic and Cardiovascular Surgery [Elsevier BV]
卷期号:164 (1): 265-275.e5 被引量:11
标识
DOI:10.1016/j.jtcvs.2021.10.033
摘要

To investigate long-term survival outcomes and develop a risk model for occult lymph node metastasis (LNM) in patients with clinical T1 through T2 N0 esophageal squamous cell carcinoma.From 2006 to 2018, 675 patients with clinical T1 through T2 N0 esophageal cancer who underwent upfront surgery were analyzed. The survival of patients with occult LNM was compared with that of 116 patients with clinical T1 through T2N+ cancer who underwent neoadjuvant therapy plus surgery. After randomly dividing the patients with clinical T1 through T2 N0 tumors into the training and testing sets, a risk model for occult LNM was developed and validated.Among patients with clinical T1 through T2 N0 esophageal cancer, occult LNM was found in 147 (21.8%) but not in 528 (78.2%). Patients with occult LNM had significantly worse prognosis than those without (P < .001), but showed similar outcomes to patients with clinical T1 through T2 N+ cancer (P = .981). According to the risk model, tumor maximum standardized uptake >3.8 (P = .002), histological differentiation grade (P = .015), tumor length >25 mm (P < .001), and advanced clinical T stage (P < .001) were independent risk factors for occult LNM in clinical T1 through T2 N0 cancer. A risk scoring system based on this model showed high accuracy (0.81) and good discriminant ability in both training sets (area under the receiver operating characteristic curve, 0.759 and testing area under the receiver operating characteristic curve, 0.743).Our risk scoring system for predicting occult LNM in clinical T1 through T2 N0 esophageal cancer has high accuracy and good discriminant ability.
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