The total number of resected lymph node is not a prognostic factor for recurrence in esophageal squamous cell carcinoma patients undergone transthoracic esophagectomy

Authors

  • Po-Kuei Hsu MD,

    1. Department of Surgery, Chutung Veterans Hospital, Hsinchu County, Taiwan
    2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    3. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    4. Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
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  • Bing-Yen Wang MD,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
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  • Teh-Ying Chou MD, PhD,

    1. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Department of Pathology, Taipei-Veterans General Hospital, Taipei, Taiwan
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  • Chien-Sheng Huang MD,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
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  • Yu-Chung Wu MD,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
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  • Wen-Hu Hsu MD

    Corresponding author
    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
    • Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. Fax: 886-2-28731488.===

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Abstract

Background

The total number of resected lymph nodes (TLN) has been shown to predict survival in esophageal cancer, but its relationship with recurrence has been rarely reported. We aim to study the prognostic factors in esophageal squamous cell carcinoma (ESCC) patients, with a particular focus on the role of TLN.

Methods

Two hundred sixty-eight ESCC patients who underwent transthoracic esophagectomy were selected for the study. A Cox regression model was used to identify prognostic factors.

Results

Recurrence occurred in 115 of 268 patients. The median time to recurrence was 10 months (range, 1–58). The recurrence-free survival at 1, 3, and 5 years was 62.3%, 32.1%, and 28.5%, respectively. Multivariate analysis identified age (P = 0.001), N stage (N1–3 vs. N0, P = 0.001), tumor length (P = 0.019), and development of recurrence (P < 0.001) as independent prognostic factors for overall survival, whereas T (T3/4 vs. T1/2, P = 0.029) and N stage (N1–3 vs. N0, P = 0.017) were independent prognostic factors for recurrence. TLN was a significant factor only when predicting overall survival in N0 patients (HR, 0.976; 95% CI, 0.953–0.999; P = 0.042).

Conclusion

The TLN is not a prognostic factor for recurrence in ESCC patients undergone transthoracic esophagectomy. J. Surg. Oncol. 2011; 103:416–420. © 2011 Wiley-Liss, Inc.

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