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

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...

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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
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Language:English
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Esophageal cancer
esophageal squamous cell carcinoma
lymph node metastasis
Lymphatic system
Metastasis
neoadjuvant chemoradiotherapy
Squamous cell carcinoma
tumor regression grade
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container_title Journal of surgical oncology
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creator 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
description 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 
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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, &lt;10%; 3, 10%−50%; 4, &gt;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 &lt; 0.05) were independent prognostic factor. The 3‐year RFS rates for patients with LN‐TRG of 1−4 grades were 72.7%, 76.5%, 37.4%, and 28.5%, respectively, and the median RFS times were not reach, 43.56, 28.09, and 22.77, respectively. Conclusions LN responder status is an independent prognostic factor for RFS in esophageal cancer patients who received NCRT.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.27555</identifier><identifier>PMID: 38124398</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Esophageal cancer ; esophageal squamous cell carcinoma ; lymph node metastasis ; Lymphatic system ; Metastasis ; neoadjuvant chemoradiotherapy ; Squamous cell carcinoma ; tumor regression grade</subject><ispartof>Journal of surgical oncology, 2024-03, Vol.129 (4), p.708-717</ispartof><rights>2023 Wiley Periodicals LLC.</rights><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3135-e467e6f3ed6afd0ba87e8ae3cd7bf2141ae5687a818a6993f8c29e442446ab6b3</cites><orcidid>0000-0002-2477-9587 ; 0000-0003-2486-6362</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38124398$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yehan, Zhou</creatorcontrib><creatorcontrib>Ying, Liu</creatorcontrib><creatorcontrib>Peng, Guo</creatorcontrib><creatorcontrib>Zongyao, Huang</creatorcontrib><creatorcontrib>Chengmin, Zhou</creatorcontrib><creatorcontrib>Hong, Yang</creatorcontrib><creatorcontrib>Sheng, Qin</creatorcontrib><creatorcontrib>Jie, Zhu</creatorcontrib><creatorcontrib>Yi, Wang</creatorcontrib><creatorcontrib>Xuefeng, Leng</creatorcontrib><creatorcontrib>Wenwu, He</creatorcontrib><creatorcontrib>Qifeng, Wang</creatorcontrib><creatorcontrib>Yang, Liu</creatorcontrib><title>Prognostic significance of positive lymph node regression grade to neoadjuvant chemoradiation for esophageal squamous cell carcinoma</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>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, &lt;10%; 3, 10%−50%; 4, &gt;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 &lt; 0.05) were independent prognostic factor. The 3‐year RFS rates for patients with LN‐TRG of 1−4 grades were 72.7%, 76.5%, 37.4%, and 28.5%, respectively, and the median RFS times were not reach, 43.56, 28.09, and 22.77, respectively. Conclusions LN responder status is an independent prognostic factor for RFS in esophageal cancer patients who received NCRT.</description><subject>Esophageal cancer</subject><subject>esophageal squamous cell carcinoma</subject><subject>lymph node metastasis</subject><subject>Lymphatic system</subject><subject>Metastasis</subject><subject>neoadjuvant chemoradiotherapy</subject><subject>Squamous cell carcinoma</subject><subject>tumor regression grade</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp10UGL1DAUB_AgijuOHvwCEvDiHrqbNGmaHGVZV2VhBfVcXtPXToY26Sbtytz94Gac1YNgLoG8H39e-BPymrMLzlh5uU_hoqyrqnpCNpwZVRhm9FOyybOykLVhZ-RFSnvGmDFKPidnQvNSCqM35OeXGAYf0uIsTW7wrncWvEUaejqH5Bb3gHQ8TPOO-tAhjThETMkFT4cI-WEJ1GOAbr8-gF-o3eEU8sDBcjR9iBRTmHcwIIw03a8whTVRi-NILUTrfJjgJXnWw5jw1eO9Jd8_XH-7-ljc3t18unp_W1jBRVWgVDWqXmCnoO9YC7pGDShsV7d9ySUHrJSuQXMNyhjRa1salLKUUkGrWrEl7065cwz3K6almVw6rgL5C2tqSsNkVVciny15-w_dhzX6vF1WZc250UxldX5SNoaUIvbNHN0E8dBw1hyraXI1ze9qsn3zmLi2E3Z_5Z8uMrg8gR9uxMP_k5rPX-9Okb8AFwGbgg</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Yehan, Zhou</creator><creator>Ying, Liu</creator><creator>Peng, Guo</creator><creator>Zongyao, Huang</creator><creator>Chengmin, Zhou</creator><creator>Hong, Yang</creator><creator>Sheng, Qin</creator><creator>Jie, Zhu</creator><creator>Yi, Wang</creator><creator>Xuefeng, Leng</creator><creator>Wenwu, He</creator><creator>Qifeng, Wang</creator><creator>Yang, Liu</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2477-9587</orcidid><orcidid>https://orcid.org/0000-0003-2486-6362</orcidid></search><sort><creationdate>20240301</creationdate><title>Prognostic significance of positive lymph node regression grade to neoadjuvant chemoradiation for esophageal squamous cell carcinoma</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3135-e467e6f3ed6afd0ba87e8ae3cd7bf2141ae5687a818a6993f8c29e442446ab6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Esophageal cancer</topic><topic>esophageal squamous cell carcinoma</topic><topic>lymph node metastasis</topic><topic>Lymphatic system</topic><topic>Metastasis</topic><topic>neoadjuvant chemoradiotherapy</topic><topic>Squamous cell carcinoma</topic><topic>tumor regression grade</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yehan, Zhou</creatorcontrib><creatorcontrib>Ying, Liu</creatorcontrib><creatorcontrib>Peng, Guo</creatorcontrib><creatorcontrib>Zongyao, Huang</creatorcontrib><creatorcontrib>Chengmin, Zhou</creatorcontrib><creatorcontrib>Hong, Yang</creatorcontrib><creatorcontrib>Sheng, Qin</creatorcontrib><creatorcontrib>Jie, Zhu</creatorcontrib><creatorcontrib>Yi, Wang</creatorcontrib><creatorcontrib>Xuefeng, Leng</creatorcontrib><creatorcontrib>Wenwu, He</creatorcontrib><creatorcontrib>Qifeng, Wang</creatorcontrib><creatorcontrib>Yang, Liu</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yehan, Zhou</au><au>Ying, Liu</au><au>Peng, Guo</au><au>Zongyao, Huang</au><au>Chengmin, Zhou</au><au>Hong, Yang</au><au>Sheng, Qin</au><au>Jie, Zhu</au><au>Yi, Wang</au><au>Xuefeng, Leng</au><au>Wenwu, He</au><au>Qifeng, Wang</au><au>Yang, Liu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic significance of positive lymph node regression grade to neoadjuvant chemoradiation for esophageal squamous cell carcinoma</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>129</volume><issue>4</issue><spage>708</spage><epage>717</epage><pages>708-717</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>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, &lt;10%; 3, 10%−50%; 4, &gt;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 &lt; 0.05) were independent prognostic factor. The 3‐year RFS rates for patients with LN‐TRG of 1−4 grades were 72.7%, 76.5%, 37.4%, and 28.5%, respectively, and the median RFS times were not reach, 43.56, 28.09, and 22.77, respectively. Conclusions LN responder status is an independent prognostic factor for RFS in esophageal cancer patients who received NCRT.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38124398</pmid><doi>10.1002/jso.27555</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2477-9587</orcidid><orcidid>https://orcid.org/0000-0003-2486-6362</orcidid></addata></record>
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subjects Esophageal cancer
esophageal squamous cell carcinoma
lymph node metastasis
Lymphatic system
Metastasis
neoadjuvant chemoradiotherapy
Squamous cell carcinoma
tumor regression grade
title Prognostic significance of positive lymph node regression grade to neoadjuvant chemoradiation for esophageal squamous cell carcinoma
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