Prognostic significance of positive lymph node regression grade to neoadjuvant chemoradiation for esophageal squamous cell carcinoma

• Published in: Journal of surgical oncology 2024-03, Vol.129 (4), p.708-717
• Main Authors: Yehan, Zhou, Ying, Liu, Peng, Guo, Zongyao, Huang, Chengmin, Zhou, Hong, Yang, Sheng, Qin, Jie, Zhu, Yi, Wang, Xuefeng, Leng, Wenwu, He, Qifeng, Wang, Yang, Liu
• Format: Article
• Language: English
• Subjects: Esophageal cancer; esophageal squamous cell carcinoma; lymph node metastasis; Lymphatic system; Metastasis; neoadjuvant chemoradiotherapy; Squamous cell carcinoma; tumor regression grade
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.27555

Background and Purpose To assess the relationship between metastatic lymph node (LN) responder status and recurrence‐free survival (RFS) in patients undergoing neoadjuvant chemoradiotherapy (NCRT). Materials and Methods We retrospectively reviewed 304 patients with local advanced esophageal squamous cell carcinoma received NCRT followed by esophagectomy. For 112 patients with positive node, according to the proportion of residual viable tumor cells area within the whole tumor beds of all metastatic LNs, we classified LN‐tumor regression grade (LN‐TRG) into four categories: grade 1, 0%; 2, 50%. Patients with grade 1−2 LN‐TRG of were considered LN responders, and those with grades 3−4, as LN nonresponders. Univariate and multivariate analyses of RFS were estimated by a Cox regression model, Kaplan−Meier curve, and log‐rank test. Results The median follow‐up time of a total of 112 patients was 29.6 months. Fifty‐two (46.4%) patients have experienced recurrence. In Cox univariate analysis, differentiation, AJCC stage LN responder status, nerve invasion, and lymphovascular invasion significantly correlated with RFS. Multivariate analysis for RFS revealed that LN responder status and AJCC stage (p