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The prognostic value of nodal skip metastasis in resectable thoracic esophageal squamous cell carcinoma

Authors Song G, Jing W, Xue S, Guo H, Yu J

Received 10 January 2017

Accepted for publication 2 May 2017

Published 25 May 2017 Volume 2017:10 Pages 2729—2736

DOI https://doi.org/10.2147/OTT.S132062

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ashok Kumar Pandurangan

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Geoffrey Pietersz

Ge Song,1,2,* Wang Jing,3,* Song Xue,1,2 Hongbo Guo,4 Jinming Yu1,2

1Department of Radiation Oncology, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences; 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated with Shandong University, Jinan, 3Department of Radiation Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 4Department of Thoracic Surgery, Shandong Cancer Hospital Affiliated with Shandong University, Jinan, China

*These authors contributed equally to the work

Purpose: This study aimed to investigate the incidence of nodal skip metastasis (NSM) to identify the risk factors that influence NSM and to assess the prognostic value of NSM in patients with thoracic esophageal squamous cell carcinoma (ESCC).
Patients and methods: Between January 2009 and December 2013, 285 patients with ESCC with positive lymph nodes who underwent complete resection were enrolled.
Results: For the entire group, NSM occurred in 32.3% (92/285) of patients. The median survival time and 5-year survival rate in the NSM group were 28 months and 12.0%, respectively, compared with 36.3 months and 25.0%, respectively, in the non-NSM group (P=0.008). Both N stage (P=0.001) and T stage (P=0.014) were associated with the incidence of NSM. NSM (P=0.008), T stage (P=0.000), and N stage (P=0.000) were independent prognostic factors for survival. In the NSM group, T stage (P=0.014) and N stage (P=0.000) were independent prognostic factors for survival.
Conclusion: It was concluded that NSM is common in ESCC and is associated with poor survival.

Keywords: esophageal squamous cell carcinoma, surgery, nodal skip metastasis, incidence, risk factors, prognosis

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