Lymphovascular Invasion as the Major Prognostic Factor in Node-Negative Esophageal Cancer After Primary Esophagectomy

Background Studies addressing both lymphovascular invasion (LVI) and perineural invasion (PNI) in patients with esophageal squamous cell carcinoma (ESCC) treated with or without neoadjuvant therapy are limited. We aimed to analyze the incidence and prognostic significance of LVI and PNI in patients...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2020-07, Vol.24 (7), p.1459-1468
Main Authors: Hsu, Chung-Ping, Chuang, Cheng-Yen, Hsu, Po-Kuei, Chien, Ling-I, Lin, Chih-Hung, Yeh, Yi-Chen, Hsu, Han-Shui, Wu, Yu-Chung
Format: Article
Language:English
Subjects:
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Esophageal cancer
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophageal Squamous Cell Carcinoma
Esophagectomy
Esophagus
Gastroenterology
Gastrointestinal surgery
Humans
Medical prognosis
Medicine
Medicine & Public Health
Neoplasm Invasiveness
Neoplasm Staging
Original Article
Prognosis
Retrospective Studies
Squamous cell carcinoma
Surgery
Survival analysis
Survival Rate
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Summary:Background Studies addressing both lymphovascular invasion (LVI) and perineural invasion (PNI) in patients with esophageal squamous cell carcinoma (ESCC) treated with or without neoadjuvant therapy are limited. We aimed to analyze the incidence and prognostic significance of LVI and PNI in patients with thoracic ESCC. Methods This retrospective study included 520 patients with ESCC: 174 patients after neoadjuvant treatment followed by surgery and 346 after primary esophagectomy, from two medical centers. The relationships between LVI, PNI, and other histological factors were evaluated. The Cox regression model was used for survival analysis. Results Positive LVI and PNI were noted in 35.6% and 22.4% of patients with residual primary tumor after neoadjuvant treatment and in 39.6% and 24.0% of patients who underwent primary esophagectomy, respectively. In patients with neoadjuvant treatments, the 5-year overall survival rates were 12.7% and 28.3% in patients with positive LVI and negative LVI, respectively ( p  = 0.001). The 5-year overall survival rates were 6.4% and 29.9% in patients with positive PNI and negative PNI, respectively ( p  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-019-04310-0