Research Papers:
The prognostic significance of celiac lymph node metastasis in patients with locally advanced esophageal squamous cell carcinoma receiving curative concurrent chemoradiotherapy
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Abstract
Yen-Hao Chen1,2,3, Hung-I Lu4, Yu-Ming Wang5, Chien-Ming Lo4, Shang-Yu Chou5, Cheng-Hua Huang1, Li-Hsueh Shih6, Su-Wei Chen7 and Shau-Hsuan Li1
1Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
3School of Medicine, Chung Shan Medical University, Taichung, Taiwan
4Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
5Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
6Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
7Department of Anesthesia, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Correspondence to:
Shau-Hsuan Li, email: [email protected]
Keywords: celiac lymph node; esophageal cancer; squamous cell carcinoma; concurrent chemoradiotherapy
Received: June 20, 2017 Accepted: September 23, 2017 Published: October 16, 2017
ABSTRACT
Background: To evaluate the clinical outcomes of celiac lymph node (LN) metastasis in patients with locally advanced esophageal squamous cell carcinoma (ESCC) receiving curative concurrent chemoradiotherapy (CCRT).
Materials and Methods: A total of 375 stage III ESCC patients were identified, including 51 patients with celiac LN metastasis and 324 patients without celiac LN metastasis. Among these 324 patients without celiac LN metastasis, 51 were matched with the 51 patients with celiac LN metastasis using the propensity score matching method.
Results: Overall, the celiac LN metastasis group had worse progression-free survival (PFS) and overall survival (OS) than the non-celiac LN metastasis group and the matched non-celiac LN metastasis group. For the ESCC patients with celiac LN metastasis, lower third ESCC was significantly associated with superior PFS and OS. For patients with upper/middle third ESCC, the celiac LN metastasis group had worse PFS and OS than the non-celiac LN metastasis group and the matched non-celiac LN metastasis group. For patients with lower third ESCC, there were no significant differences in PFS and OS between these groups.
Conclusions: Our study suggests celiac LN metastasis is a poor prognostic factor for locally advanced ESCC patients receiving curative CCRT. Among these ESCC patients with celiac LN metastasis, tumor location is a strongly prognostic factor, indicating patients with lower third ESCC have better PFS and OS than those with upper/middle third ESCC. The 6th American Joint Committee on Cancer staging system seems more favorable than 7th edition in the definition of celiac LNs for those patients.
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