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Clinical Significance of the Pre-therapeutic Nodal Size in Patients Undergoing Neo-Adjuvant Treatment Followed by Esophagectomy for Esophageal Squamous Cell Carcinoma

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Abstract

Background

The clinical significance of pre-therapeutic nodal size in patients with esophageal squamous cell carcinoma (ESCC) is not clear. We investigated whether nodal size was correlated with survival in patients undergoing neo-adjuvant treatment followed by esophagectomy for ESCC.

Methods

In 2009–2013, 222 patients who underwent neo-adjuvant treatment followed by esophagectomy for ESCC were enrolled in this retrospective study. Nodal size was measured along the short axis of the largest node using pre-therapeutic CT images. Patients were then stratified based on this short axis, and nodal size was correlated with clinicopathological factors and survival.

Results

Patients with larger nodes were likely to have deeper cT, higher cN status, and poorer survival. Among the clinical factors cT, cN, cM, and nodal size, only cT and nodal size were independent prognostic factors in multivariate analysis [hazard ratio (HR) 2.0, 95 % confidence interval (CI) 1.1–3.5, p = 0.025 and HR 1.5, 95 % CI 1–2.3, p = 0.036, respectively]. In addition, nodal size was significantly associated with hematological recurrence (p = 0.007), but not lymphatic relapse (p = 0.272).

Conclusions

The short axis of the largest node before neo-adjuvant treatment in patients with ESCC is a prognostic factor.

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Acknowledgments

We appreciate the kind support of Dr. Takazawa Y. as a pathologist.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Shinji Mine, Masayuki Watanabe, Yu Imamura, Akihiko Okamura, Takanori Kurogochi & Takeshi Sano

  2. Department of Esophageal and Gastroenterological Surgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Shinji Mine

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  1. Shinji Mine
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  2. Masayuki Watanabe
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Correspondence to Shinji Mine.

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Mine, S., Watanabe, M., Imamura, Y. et al. Clinical Significance of the Pre-therapeutic Nodal Size in Patients Undergoing Neo-Adjuvant Treatment Followed by Esophagectomy for Esophageal Squamous Cell Carcinoma. World J Surg 41, 184–190 (2017). https://doi.org/10.1007/s00268-016-3675-y

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