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The Prognostic Value of Lymph Node Ratio in Locally Advanced Esophageal Cancer Patients Who Received Neoadjuvant Chemotherapy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The lymph node (LN) ratio (LNR) has been proposed as a sensitive prognosticator in patients with esophageal squamous cell carcinoma (ESCC), especially when the number of LNs harvested is insufficient. We investigated the association between the LNR and survival in patients with locally advanced ESCC who received neoadjuvant chemotherapy (NAC) and explored whether the LNR is a prognosticator in these patients when stratified by their response to NAC.

Methods

We retrospectively reviewed 199 locally advanced ESCC patients who received curative resection after NAC between January 2011 and December 2019. The predictive accuracy of the adjusted X-tile cut-off values for LNR of 0 and 0.13 was compared with that in the Union for International Cancer Control pathological N (UICC pN) categories. The association between survival rate and clinicopathological features was examined.

Results

Multivariate analysis identified that the LNR was an independent risk factor for recurrence-free survival [RFS; hazard ratio (HR) 6.917, p < 0.001] and overall survival (OS) (HR 4.998, p < 0.001). Moreover, even when stratified by response to NAC, the LNR was a significant independent risk factor for RFS and OS (p < 0.001). The receiver operating characteristic curves identified that the prognostic accuracy of the LNR tended to be better than that of the UICC pN factor in all cases and responders.

Conclusion

The LNR had a significant prognostic value in patients with locally advanced ESCC, including in those who received NAC.

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Acknowledgment

The authors express their sincere gratitude to Ms. Rika Takahashi for her excellent data management.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan

    Kazuki Kano MD, PhD, Takanobu Yamada MD, PhD, Keisuke Komori MD, Hayato Watanabe MD, Kosuke Takahashi MD, Hirohito Fujikawa MD, PhD, Takashi Ogata MD, PhD & Takashi Oshima MD, PhD

  2. Department of Surgery, Yokohama City University, Yokohama, Kanagawa, Japan

    Kazuki Kano MD, PhD, Takanobu Yamada MD, PhD, Keisuke Komori MD, Hayato Watanabe MD, Hirohito Fujikawa MD, PhD, Masakatsu Numata MD, PhD, Toru Aoyama MD, PhD, Hiroshi Tamagawa MD, PhD, Norio Yukawa MD, PhD, Yasushi Rino MD, PhD & Munetaka Masuda MD, PhD

Authors
  1. Kazuki Kano MD, PhD
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  2. Takanobu Yamada MD, PhD
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  3. Keisuke Komori MD
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  4. Hayato Watanabe MD
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  5. Kosuke Takahashi MD
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  6. Hirohito Fujikawa MD, PhD
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  7. Masakatsu Numata MD, PhD
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  8. Toru Aoyama MD, PhD
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  9. Hiroshi Tamagawa MD, PhD
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  10. Norio Yukawa MD, PhD
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  11. Yasushi Rino MD, PhD
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  12. Munetaka Masuda MD, PhD
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  13. Takashi Ogata MD, PhD
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  14. Takashi Oshima MD, PhD
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Corresponding author

Correspondence to Takashi Oshima MD, PhD.

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Disclosures

Yasushi Rino has received speakers’ bureau fees from Daiichi Sankyo, Johnson & Johnson, Otsuka, Lilly, Taiho Pharmaceutical, Ono Pharmaceutical, and Bristol-Myers Squibb, as well as research funding (paid to the institution) from Taiho Pharmaceutical, Nutrition, Asahi Kasei, Daiichi Sankyo, Tsumura & Co., Covidien, Zeria Pharmaceutical, Otsuka, EA Pharma, Johnson & Johnson, Taiho Pharmaceutical, Tsumura & Co., and Kaken Pharmaceutical. Kazuki Kano, Takanobu Yamada, Keisuke Komori, Hayato Watanabe, Kosuke Takahashi, Hirohito Fujikawa, Masakatsu Numata, Toru Aoyama, Hiroshi Tamagawa, Norio Yukawa, Yasushi Rino, Munetaka Masuda, and Takashi Ogata have no disclosures to declare.

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Kano, K., Yamada, T., Komori, K. et al. The Prognostic Value of Lymph Node Ratio in Locally Advanced Esophageal Cancer Patients Who Received Neoadjuvant Chemotherapy. Ann Surg Oncol 28, 8464–8472 (2021). https://doi.org/10.1245/s10434-021-10240-6

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  • DOI: https://doi.org/10.1245/s10434-021-10240-6

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