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Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer

The purpose of this study was to determine whether the number of lymph nodes dissected predicts prognosis in surgically treated elderly patients with pN0 thoracic esophageal cancer. We searched the Surveillance, Epidemiology, and End Results database and identified the records of younger (<75 yea...

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Autores principales: Zhang, Guoqing, Guo, Xiaofeng, Yuan, Lulu, Gao, Zhen, Li, Jindong, Li, Xiangnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808502/
https://www.ncbi.nlm.nih.gov/pubmed/33466178
http://dx.doi.org/10.1097/MD.0000000000024100
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author Zhang, Guoqing
Guo, Xiaofeng
Yuan, Lulu
Gao, Zhen
Li, Jindong
Li, Xiangnan
author_facet Zhang, Guoqing
Guo, Xiaofeng
Yuan, Lulu
Gao, Zhen
Li, Jindong
Li, Xiangnan
author_sort Zhang, Guoqing
collection PubMed
description The purpose of this study was to determine whether the number of lymph nodes dissected predicts prognosis in surgically treated elderly patients with pN0 thoracic esophageal cancer. We searched the Surveillance, Epidemiology, and End Results database and identified the records of younger (<75 years) and older (≥75 years) patients with pN0 thoracic esophageal cancer between 1998 and 2015. The patient characteristics, tumor data, and postoperative variables were analyzed in this study. The Kaplan-Meier method and a Cox proportional hazard model were used to compare overall and cause-specific survival. Data from 1,792 esophageal cancer patients (older: n = 295; younger: n = 1497) were included. The survival analysis showed that the overall and cause-specific survival in the patients with ≥15 examined lymph nodes (eLNs) was significantly superior to that in the patients with 1 to 14 eLNs (P < .001); however, the difference disappeared in the older patients. After stratification by the tumor location, histology, pT classification, and differentiation between the younger and older cohorts to analyze the association between eLNs and survival, we found that the differences remained significant in most subgroups in the younger cohort. There were no differences in any subgroups of older patients. This study replicated the previously identified finding that long-term survival in patients with extensive lymphadenectomy was significantly superior to that in patients with less extensive lymphadenectomy. However, less extensive lymphadenectomy may be an acceptable treatment modality for elderly patients with pN0 thoracic esophageal cancer.
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spelling pubmed-78085022021-01-15 Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer Zhang, Guoqing Guo, Xiaofeng Yuan, Lulu Gao, Zhen Li, Jindong Li, Xiangnan Medicine (Baltimore) 7100 The purpose of this study was to determine whether the number of lymph nodes dissected predicts prognosis in surgically treated elderly patients with pN0 thoracic esophageal cancer. We searched the Surveillance, Epidemiology, and End Results database and identified the records of younger (<75 years) and older (≥75 years) patients with pN0 thoracic esophageal cancer between 1998 and 2015. The patient characteristics, tumor data, and postoperative variables were analyzed in this study. The Kaplan-Meier method and a Cox proportional hazard model were used to compare overall and cause-specific survival. Data from 1,792 esophageal cancer patients (older: n = 295; younger: n = 1497) were included. The survival analysis showed that the overall and cause-specific survival in the patients with ≥15 examined lymph nodes (eLNs) was significantly superior to that in the patients with 1 to 14 eLNs (P < .001); however, the difference disappeared in the older patients. After stratification by the tumor location, histology, pT classification, and differentiation between the younger and older cohorts to analyze the association between eLNs and survival, we found that the differences remained significant in most subgroups in the younger cohort. There were no differences in any subgroups of older patients. This study replicated the previously identified finding that long-term survival in patients with extensive lymphadenectomy was significantly superior to that in patients with less extensive lymphadenectomy. However, less extensive lymphadenectomy may be an acceptable treatment modality for elderly patients with pN0 thoracic esophageal cancer. Lippincott Williams & Wilkins 2021-01-15 /pmc/articles/PMC7808502/ /pubmed/33466178 http://dx.doi.org/10.1097/MD.0000000000024100 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 7100
Zhang, Guoqing
Guo, Xiaofeng
Yuan, Lulu
Gao, Zhen
Li, Jindong
Li, Xiangnan
Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title_full Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title_fullStr Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title_full_unstemmed Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title_short Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
title_sort examined lymph node count is not associated with prognosis in elderly patients with pn0 thoracic esophageal cancer
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808502/
https://www.ncbi.nlm.nih.gov/pubmed/33466178
http://dx.doi.org/10.1097/MD.0000000000024100
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