Cargando…
Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes
BACKGROUND: The overall survival (OS) remains unsatisfactory in patients with esophageal squamous cell carcinoma (ESCC) after extended esophagectomy with two-field lymphadenectomy. Therefore, this retrospective study aimed to identify the risk factors that contribute to the low survival of patients...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088719/ https://www.ncbi.nlm.nih.gov/pubmed/33933129 http://dx.doi.org/10.1186/s13019-021-01503-0 |
_version_ | 1783686901192982528 |
---|---|
author | Qi, Zhan Hu, Yuanping Qiu, Rong Li, Juan Li, Yuekao He, Ming Wang, Yuxiang |
author_facet | Qi, Zhan Hu, Yuanping Qiu, Rong Li, Juan Li, Yuekao He, Ming Wang, Yuxiang |
author_sort | Qi, Zhan |
collection | PubMed |
description | BACKGROUND: The overall survival (OS) remains unsatisfactory in patients with esophageal squamous cell carcinoma (ESCC) after extended esophagectomy with two-field lymphadenectomy. Therefore, this retrospective study aimed to identify the risk factors that contribute to the low survival of patients with pT(1–3)N(0)M(0) ESCC. METHODS: Patients with pT(1–3)N(0)M(0) ESCC who only underwent R0 esophagectomy with two-field lymphadenectomy in our department from January 2008 to December 2012 were retrospectively enrolled in this study and medical records were reviewed. Postoperative OS, disease-free survival (DFS), recurrence-free survival (RFS), and locoregional recurrence-free survival (LRFS) were analyzed sequentially. RESULTS: This study recruited a total of 488 patients, whose follow-up visits were completed at the end of December 2019. The five-year OS, DFS, RFS and LRFS rates were 62.1, 53.1, 58.3 and 65.6%, respectively. Multivariate Cox analysis identified patient age, site of the lesion, small mediastinal lymph nodes in CT imaging (SLNs in CT), dissected lymph nodes (LNs), and stage of esophageal malignancy as independent risk factors for OS of the patients. Of these factors, the site of the lesion, SLNs in CT and stage of the cancer were determined to be independent factors for DFS, RFS and LRFS. Based on all five factors, the recursive partitioning analysis (RPA) score system was developed to stratify the patients into low-, medium- and high-risk groups, which were found to possess significantly different rates of OS, DFS, RFS and LRFS (p < 0.001). CONCLUSIONS: Several factors were associated with the survival of patients with pT(1–3) N(0)M(0) ESCC who underwent extended esophagectomy with two-field lymphadenectomy. These factors contributed to the RPA scoring system, which could stratify the risk of postoperative survival and may expedite the initiation of postoperative adjuvant therapy. |
format | Online Article Text |
id | pubmed-8088719 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80887192021-05-04 Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes Qi, Zhan Hu, Yuanping Qiu, Rong Li, Juan Li, Yuekao He, Ming Wang, Yuxiang J Cardiothorac Surg Research Article BACKGROUND: The overall survival (OS) remains unsatisfactory in patients with esophageal squamous cell carcinoma (ESCC) after extended esophagectomy with two-field lymphadenectomy. Therefore, this retrospective study aimed to identify the risk factors that contribute to the low survival of patients with pT(1–3)N(0)M(0) ESCC. METHODS: Patients with pT(1–3)N(0)M(0) ESCC who only underwent R0 esophagectomy with two-field lymphadenectomy in our department from January 2008 to December 2012 were retrospectively enrolled in this study and medical records were reviewed. Postoperative OS, disease-free survival (DFS), recurrence-free survival (RFS), and locoregional recurrence-free survival (LRFS) were analyzed sequentially. RESULTS: This study recruited a total of 488 patients, whose follow-up visits were completed at the end of December 2019. The five-year OS, DFS, RFS and LRFS rates were 62.1, 53.1, 58.3 and 65.6%, respectively. Multivariate Cox analysis identified patient age, site of the lesion, small mediastinal lymph nodes in CT imaging (SLNs in CT), dissected lymph nodes (LNs), and stage of esophageal malignancy as independent risk factors for OS of the patients. Of these factors, the site of the lesion, SLNs in CT and stage of the cancer were determined to be independent factors for DFS, RFS and LRFS. Based on all five factors, the recursive partitioning analysis (RPA) score system was developed to stratify the patients into low-, medium- and high-risk groups, which were found to possess significantly different rates of OS, DFS, RFS and LRFS (p < 0.001). CONCLUSIONS: Several factors were associated with the survival of patients with pT(1–3) N(0)M(0) ESCC who underwent extended esophagectomy with two-field lymphadenectomy. These factors contributed to the RPA scoring system, which could stratify the risk of postoperative survival and may expedite the initiation of postoperative adjuvant therapy. BioMed Central 2021-05-01 /pmc/articles/PMC8088719/ /pubmed/33933129 http://dx.doi.org/10.1186/s13019-021-01503-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Qi, Zhan Hu, Yuanping Qiu, Rong Li, Juan Li, Yuekao He, Ming Wang, Yuxiang Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title | Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title_full | Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title_fullStr | Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title_full_unstemmed | Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title_short | Survival risk prediction model for patients with pT(1–3) N(0)M(0) esophageal squamous cell carcinoma after R0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
title_sort | survival risk prediction model for patients with pt(1–3) n(0)m(0) esophageal squamous cell carcinoma after r0 esophagectomy with two-field lymphadenectomy for therapeutic purposes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088719/ https://www.ncbi.nlm.nih.gov/pubmed/33933129 http://dx.doi.org/10.1186/s13019-021-01503-0 |
work_keys_str_mv | AT qizhan survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT huyuanping survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT qiurong survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT lijuan survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT liyuekao survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT heming survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes AT wangyuxiang survivalriskpredictionmodelforpatientswithpt13n0m0esophagealsquamouscellcarcinomaafterr0esophagectomywithtwofieldlymphadenectomyfortherapeuticpurposes |