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Mapping of Lymph Node Metastasis and Efficacy Index in Thoracic Esophageal Squamous Cell Carcinoma: A Large-Scale Retrospective Analysis

Annals of Surgical Oncology volume 30, pages 5856–5865 (2023)Cite this article

Abstract

Background

Esophageal squamous cell carcinoma has a high mortality rate in China. The metastatic pattern in the lymph nodes and the value of their dissection on the overall survival of these patients remain controversial. The primary aim of this study was to provide a basis for accurate staging of esophageal cancer and to identify the relationship between esophageal cancer surgery, lymph node dissection, and overall survival rates.

Methods

We utilized our hospital database to retrospectively review the data of 1727 patients with esophageal cancer who underwent R0 esophagectomy from January 2010 to December 2017. The lymph nodes were defined according to Japanese Classification of Esophageal Cancer, 11th Edition. The Efficacy Index (EI) was calculated by multiplying the frequency (%) of metastases to a zone and the 5-year survival rate (%) of patients with metastases to that zone, and then dividing by 100.

Results

The EI was high in the supraclavicular and mediastinal zones in patients with upper esophageal tumors, and the EI of 101R was 17.39, which was the highest among the lymph node stations. In patients with middle esophageal tumors, the EI was highest in the mediastinal zone, followed by the celiac and supraclavicular zones. Furthermore, the EI was highest in the celiac zone, followed by the mediastinal zones in patients with lower esophageal tumors.

Conclusions

The EI of resected lymph nodes was found to vary between stations and was related to the primary location of the tumor.

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Fig. 1
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Acknowledgment

Special thanks to Qifeng Wang (The Science and Technology Department of Sichuan Province (2023YFS0488 and 2023YFQ0055) for financial support, Reeyan Jiang for the creating Fig. 2 and everyone who has contributed to the database.

Funding

This work was supported by grants from the National Key Research and Development Program (2022YFC2403400), International Cooperation Projects of Science and Technology Department of Sichuan Province (Grant No. 2020YFH0169), the Sichuan Key Research and Development Project from Science and Technology Department of Sichuan Province (Grant No. 2023YFS0044, 2023YFQ0056, No. 2021YJ0118), the Wu Jieping Clinical Research Projects (Grant No. 320.6750.2020-15-3), and Sichuan Province Clinical Key Specialty Construction Project.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China

    Kexun Li MD, Xin Nie MD, Changding Li MD, Wenwu He MD, PhD, Chenghao Wang MD, PhD, Kunyi Du MD, Kunzhi Li MD, Kun Liu MD, Zhiyu Li MD, Simiao Lu MD, Kunhan Ni MD, Yixuan Huang MD, Longlin Jiang MD, Kangning Wang MD, PhD, Haojun Li MD, Qiang Fang MD, PhD, Wenguang Xiao MD, Yongtao Han MD, Xuefeng Leng MD, PhD & Lin Peng MD

Authors
  1. Kexun Li MD
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  2. Xin Nie MD
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  3. Changding Li MD
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  4. Wenwu He MD, PhD
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  5. Chenghao Wang MD, PhD
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  15. Haojun Li MD
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  16. Qiang Fang MD, PhD
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  19. Xuefeng Leng MD, PhD
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Contributions

Study concept and design; acquisition, analysis, or interpretation of data; revising the article critically for important intellectual content; final approval of the version to be published: All authors. Drafting of the article: KL. Statistical analysis: XN. Obtained funding: LP. Administrative, technical, or material support: XL, LP. Study supervision: YH, LP, KL, XN, and CL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. KL, XN, and CL have contributed equally to this work.

Corresponding authors

Correspondence to Xuefeng Leng MD, PhD or Lin Peng MD.

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Disclosure

Kexun Li, Xin Nie, Changding Li, Wenwu He, Chenghao Wang, Kunyi Du, Kunzhi Li, Kun Liu, Zhiyu Li, Simiao Lu, Kunhan Ni, Yixuan Huang, Longlin Jiang, Kangning Wang, Haojun Li, Qiang Fang, Wenguang Xiao, Yongtao Han, Xuefeng Leng, and Lin Peng declare they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Ethical Approval

This study was approved by the EC for Medical Research and New Medical Technology of Sichuan Cancer Hospital (SCCHEC-02-2022-050).

Informed Consent

The data are anonymous and the requirement for informed consent was therefore waived.

Meeting presentations

Partial preliminary results of this article were reported in the Featured Abstracts presented by the first author of this article at the 18th World Congress for Esophageal Diseases (ISDE 2022), which was held virtually from 26 to 29 September 2022. Partial preliminary results of this article were reported in the Excellent Abstracts presented to the Chinese Conference on Oncology (CCO), which was held virtually from 17 to 20 November 2022.

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Li, K., Nie, X., Li, C. et al. Mapping of Lymph Node Metastasis and Efficacy Index in Thoracic Esophageal Squamous Cell Carcinoma: A Large-Scale Retrospective Analysis. Ann Surg Oncol 30, 5856–5865 (2023). https://doi.org/10.1245/s10434-023-13655-5

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