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Surgery Today

, Volume 49, Issue 2, pp 158–169 | Cite as

BRF2 as a promising indicator for radical lymph-node dissection surgery in patients with cN0 squamous cell carcinoma of the middle thoracic esophagus

  • Yu Tian
  • Cong Wang
  • Ming LuEmail author
Original Article
  • 49 Downloads

Abstract

Purpose

Radical lymph-node dissection surgery in patients with cN0 middle thoracic esophageal squamous cell carcinoma (ESCC) remains controversial. We sought a novel biomarker that could be used for decision-making in relation to radical lymph-node dissection.

Methods

One hundred and nineteen patients with cN0 middle thoracic ESCC undergoing three-field lymph-node dissection (3FLND) or two-field lymph-node dissection (Ivor Lewis) esophagectomy were reviewed. A survival analysis, and Chi-square and parametric tests were performed.

Results

A Cox regression analysis revealed that the expression of BRF2 was an independent prognostic factor for overall survival (P = 0.014) and progression-free survival (P = 0.014). The survival of patients who underwent 3FLND was better than that of patients who underwent Ivor Lewis esophagectomy in the BRF2 overexpression group (P = 0.002), but not in the BRF2 nonoverexpression group (P = 0.386). The risk of lymph-node recurrence and the number of recurrent lymph nodes in patients with the overexpression of BRF2 were increased in the Ivor Lewis group in comparison to the 3FLND group (P = 0.01 and P < 0.001). The risk of cervical and superior mediastinal lymph-node recurrence was positively correlated with the overexpression of BRF2 (P = 0.027). Furthermore, in the Ivor Lewis group, a significant correlation was found between the risk of lymph-node recurrence or the number of recurrent lymph nodes and the expression of BRF2 (P = 0.002 and P = 0.004), but not in the 3FLND group (P = 0.193 and P = 0.694).

Conclusions

3FLND generated better survival outcomes and reduced the rate of lymph-node recurrence in comparison to Ivor Lewis in patients with the overexpression of BRF2. BRF2 can be used as an indicator for radical lymph-node dissection surgery in cN0 ESCC patients.

Keywords

BRF2 Esophageal squamous cell cancer 3FLND Ivor Lewis 

Abbreviations

BRF2

TFIIB-related factor 2

ESCC

Esophageal squamous cell cancer

3FLND

Three-field lymph-node dissection esophagectomy

Ivor Lewis

Two-field lymph-node dissection esophagectomy

OS

Overall survival

PFS

Progression-free survival

Notes

Funding

This work was supported by National Natural Science Foundation of Shandong Province (ZR2017PH018).

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with the present study.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryThe Second Hospital of Shandong UniversityJinanPeople’s Republic of China
  2. 2.Department of Radiation Oncology, Qilu HospitalShandong UniversityJinanPeople’s Republic of China
  3. 3.Department of Thoracic Surgery, Qilu HospitalShandong UniversityJinanPeople’s Republic of China

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