Cargando…

Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis

BACKGROUND: Lymph node metastasis (LNM) affects the application and outcomes of endoscopic resection in T1 esophageal squamous cell carcinoma (ESCC). However, reports of the risk factors for LNM have been controversial. AIM: To evaluate risk factors for LNM in T1 ESCC. METHODS: We searched Embase, P...

Descripción completa

Detalles Bibliográficos
Autores principales: Jiang, Kai-Yuan, Huang, Heng, Chen, Wei-Yang, Yan, Hao-Ji, Wei, Zhen-Ting, Wang, Xiao-Wen, Li, Hao-Xuan, Zheng, Xiang-Yun, Tian, Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934003/
https://www.ncbi.nlm.nih.gov/pubmed/33716451
http://dx.doi.org/10.3748/wjg.v27.i8.737
_version_ 1783660737871216640
author Jiang, Kai-Yuan
Huang, Heng
Chen, Wei-Yang
Yan, Hao-Ji
Wei, Zhen-Ting
Wang, Xiao-Wen
Li, Hao-Xuan
Zheng, Xiang-Yun
Tian, Dong
author_facet Jiang, Kai-Yuan
Huang, Heng
Chen, Wei-Yang
Yan, Hao-Ji
Wei, Zhen-Ting
Wang, Xiao-Wen
Li, Hao-Xuan
Zheng, Xiang-Yun
Tian, Dong
author_sort Jiang, Kai-Yuan
collection PubMed
description BACKGROUND: Lymph node metastasis (LNM) affects the application and outcomes of endoscopic resection in T1 esophageal squamous cell carcinoma (ESCC). However, reports of the risk factors for LNM have been controversial. AIM: To evaluate risk factors for LNM in T1 ESCC. METHODS: We searched Embase, PubMed and Cochrane Library to select studies related to LNM in patients with T1 ESCC. Included studies were divided into LNM and non-LNM groups. We performed a meta-analysis to examine the relationship between LNM and clinicopathologic features. Odds ratio (OR), mean differences and 95% confidence interval (CI) were assessed using a fixed-effects or random-effects model. RESULTS: Seventeen studies involving a total of 3775 patients with T1 ESCC met the inclusion criteria. After excluding studies with heterogeneity based on influence analysis, tumor size (OR = 1.93, 95%CI = 1.49-2.50, P < 0.001), tumor location (OR = 1.46, 95%CI = 1.17-1.82, P < 0.001), macroscopic type (OR = 3.17, 95%CI = 2.33-4.31, P < 0.001), T1 substage (OR = 6.28, 95%CI = 4.93-8.00, P < 0.001), differentiation (OR = 2.11, 95%CI = 1.64-2.72, P < 0.001) and lymphovascular invasion (OR = 5.86, 95%CI = 4.60-7.48, P < 0.001) were found to be significantly associated with LNM. Conversely, sex, age and infiltrative growth pattern were not identified as risk factors for LNM. CONCLUSION: A tumor size > 2 cm, lower location, nonflat macroscopic type, T1b stage, poor differentiation and lymphovascular invasion were associated with LNM in patients with T1 ESCC.
format Online
Article
Text
id pubmed-7934003
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-79340032021-03-11 Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis Jiang, Kai-Yuan Huang, Heng Chen, Wei-Yang Yan, Hao-Ji Wei, Zhen-Ting Wang, Xiao-Wen Li, Hao-Xuan Zheng, Xiang-Yun Tian, Dong World J Gastroenterol Meta-Analysis BACKGROUND: Lymph node metastasis (LNM) affects the application and outcomes of endoscopic resection in T1 esophageal squamous cell carcinoma (ESCC). However, reports of the risk factors for LNM have been controversial. AIM: To evaluate risk factors for LNM in T1 ESCC. METHODS: We searched Embase, PubMed and Cochrane Library to select studies related to LNM in patients with T1 ESCC. Included studies were divided into LNM and non-LNM groups. We performed a meta-analysis to examine the relationship between LNM and clinicopathologic features. Odds ratio (OR), mean differences and 95% confidence interval (CI) were assessed using a fixed-effects or random-effects model. RESULTS: Seventeen studies involving a total of 3775 patients with T1 ESCC met the inclusion criteria. After excluding studies with heterogeneity based on influence analysis, tumor size (OR = 1.93, 95%CI = 1.49-2.50, P < 0.001), tumor location (OR = 1.46, 95%CI = 1.17-1.82, P < 0.001), macroscopic type (OR = 3.17, 95%CI = 2.33-4.31, P < 0.001), T1 substage (OR = 6.28, 95%CI = 4.93-8.00, P < 0.001), differentiation (OR = 2.11, 95%CI = 1.64-2.72, P < 0.001) and lymphovascular invasion (OR = 5.86, 95%CI = 4.60-7.48, P < 0.001) were found to be significantly associated with LNM. Conversely, sex, age and infiltrative growth pattern were not identified as risk factors for LNM. CONCLUSION: A tumor size > 2 cm, lower location, nonflat macroscopic type, T1b stage, poor differentiation and lymphovascular invasion were associated with LNM in patients with T1 ESCC. Baishideng Publishing Group Inc 2021-02-28 2021-02-28 /pmc/articles/PMC7934003/ /pubmed/33716451 http://dx.doi.org/10.3748/wjg.v27.i8.737 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Meta-Analysis
Jiang, Kai-Yuan
Huang, Heng
Chen, Wei-Yang
Yan, Hao-Ji
Wei, Zhen-Ting
Wang, Xiao-Wen
Li, Hao-Xuan
Zheng, Xiang-Yun
Tian, Dong
Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title_full Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title_fullStr Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title_full_unstemmed Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title_short Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma: A systematic review and meta-analysis
title_sort risk factors for lymph node metastasis in t1 esophageal squamous cell carcinoma: a systematic review and meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934003/
https://www.ncbi.nlm.nih.gov/pubmed/33716451
http://dx.doi.org/10.3748/wjg.v27.i8.737
work_keys_str_mv AT jiangkaiyuan riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT huangheng riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT chenweiyang riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT yanhaoji riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT weizhenting riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT wangxiaowen riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT lihaoxuan riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT zhengxiangyun riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis
AT tiandong riskfactorsforlymphnodemetastasisint1esophagealsquamouscellcarcinomaasystematicreviewandmetaanalysis