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.
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.
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.
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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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.
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.
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.
This study was approved by the EC for Medical Research and New Medical Technology of Sichuan Cancer Hospital (SCCHEC-02-2022-050).
The data are anonymous and the requirement for informed consent was therefore waived.
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