The Metastatic Lymph Node Number and Ratio Are Independent Prognostic Factors in Esophageal Cancer

  • Wen-Hu Hsu
  • Po-Kuei Hsu
  • Chih-Cheng Hsieh
  • Chien-Sheng Huang
  • Yu-Chung Wu
2009 SSAT Poster Presentation

Abstract

Objective

The current American Joint Committee on Cancer staging system for esophageal cancer is based on lymph node location, irrespective of the number of involved and examined lymph nodes.

Methods

We enrolled 488 patients receiving primary curative resection without neoadjuvant therapy for esophageal cancer between 1995 and 2006. The importance of total resected lymph node number (TLN) and metastatic lymph node number (MLN) and ratio (MLR) on patient survival was investigated.

Results

The overall 3-year survival rate was 35.4%. The 3-year survival rate was equivalent among patients in N1 (23.3%), M1a (22.0%), and nonregional lymph node metastasis-related M1b (18.5%, p = 0.321). No survival difference was noted between patients with TLN < 15 or ≥15 (p = 0.249). Both MLN and MLR significantly predicted patient survival. The 3-year survival rate was 52.3%, 29.2%, and 8.0% for patients with MLN = 0, 1–3, and ≥4, respectively (p < 0.001). For patients with MLR = 0–0.2 or >0.2, the 3-year survival rate was 28.7% and 9.8%, respectively (p < 0.001). However, survival rate differences were more evident when TLN was more than 15.

Conclusions

We recommend designating both regional and nonregional lymph nodes as N nodes. MLN and MLR, but not TLN, are prognostic factors in esophageal cancer.

Keywords

Esophageal cancer Lymph node metastasis Prognosis 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • Wen-Hu Hsu
    • 1
    • 2
    • 3
  • Po-Kuei Hsu
    • 1
    • 2
    • 4
  • Chih-Cheng Hsieh
    • 1
    • 2
    • 4
  • Chien-Sheng Huang
    • 1
    • 2
  • Yu-Chung Wu
    • 1
    • 2
  1. 1.Division of Thoracic Surgery, Department of SurgeryTaipei-Veterans General HospitalTaipeiTaiwan
  2. 2.School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.School of MedicineTaipei Medical UniversityTaipeiTaiwan
  4. 4.Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan

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