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The Significance of Negative Lymph Nodes in Esophageal Cancer After Curative Resection: A Retrospective Cohort Study

Authors Mo J, Chen D, Li C, Chen M

Received 29 September 2019

Accepted for publication 16 January 2020

Published 20 February 2020 Volume 2020:12 Pages 1269—1279


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Yong Teng

Junxian Mo,1,2,* Dongni Chen,3,* Changbo Li,2 Mingwu Chen1

1Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China; 2Department of Cardio-Thoracic Surgery, The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou, Guangxi 543000, People’s Republic of China; 3Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Mingwu Chen
Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China

Objective: The impact of negative lymph nodes (NLNs) count on prognosis in esophageal cancer (EC) was analyzed using two institutions surgical database.
Methods: We conducted a retrospective study of 768 EC patients treated by surgical resection between January 2010 and December 2012. The effects of the NLNs count on prognosis was analyzed. Cox regression model was conducted to determine the significant prognostic elements.
Results: The number of NLNs was studied as a categorical variable based on the quartiles (Q1: ≤ 15, Q2: 16– 21, Q3: 22– 30, Q4: ≥ 31). And a better overall survival (OS) was observed with increasing number of NLNs (HR= 0.762; 95% CI, 0.596– 0.974 for Q2, HR= 0.666; 95% CI, 0.516– 0.860 for Q3 and HR= 0.588; 95% CI, 0.450– 0.768 for Q4) (all P< 0.05). Multivariate regression analysis revealed that the NLNs count was an independent prognostic factor. Besides, for patients in T2 or T3 stage, a high number of NLNs was found to be significantly associated with a favorable OS (log rank P< 0.001).
Conclusion: A higher number of NLNs is independently related to the better OS in EC patients after surgical resection.

Keywords: esophageal cancer, negative lymph node, prognostic factor

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