Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2023; 29(47): 6138-6147
Published online Dec 21, 2023. doi: 10.3748/wjg.v29.i47.6138
Risk factors and a predictive nomogram for lymph node metastasis in superficial esophageal squamous cell carcinoma
Jin Wang, Xian Zhang, Tao Gan, Ni-Ni Rao, Kai Deng, Jin-Lin Yang
Jin Wang, Tao Gan, Kai Deng, Jin-Lin Yang, Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Xian Zhang, Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ni-Ni Rao, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610064, Sichuan Province, China
Author contributions: Wang J and Deng K designed and performed the research; Wang J, Zhang X and Gan T collected and analyzed the data; Wang J and Zhang X wrote the manuscript; Deng K, Rao NN and Yang JL supervised the report and revised the manuscript.
Supported by the National Natural Science Foundation of China, No. 82173253; the Sichuan Province Science and Technology Support Program, No. 2022YFH0003 and No. 2023NSFSC1900; the Postdoctoral Research Foundation of West China Hospital, No. 2021HXBH020; and the Medico- Engineering Cooperation Funds from the University of Electronic Science and Technology of China and West China Hospital of Sichuan University, No. HXDZ22005.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of West China Hospital of Sichuan University, approval No. 2015(159).
Informed consent statement: All study participants who underwent esophagectomy were provided informed written consent prior to surgery.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Lin Yang, MD, PhD, Chief Physician, Professor, Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu 610041, Sichuan Province, China. yangjinlin@wchscu.cn
Received: August 4, 2023
Peer-review started: August 4, 2023
First decision: October 25, 2023
Revised: November 7, 2023
Accepted: December 8, 2023
Article in press: December 8, 2023
Published online: December 21, 2023
ARTICLE HIGHLIGHTS
Research background

Endoscopic resection of superficial esophageal squamous cell carcinoma (ESCC) is limited to lesions that have no or low risk of lymph node metastasis (LNM). Patients with a high risk of LNM always need further treatment after endoscopic resection.

Research motivation

Accurately assessing the LNM risk is critical for additional treatment choices for superficial ESCC patients who underwent endoscopic resection.

Research objectives

This study aimed to analyze the risk factors for LNM and develop a LNM predictive nomogram for superficial ESCC patients.

Research methods

Clinical and pathological data from superficial ESCC patients underwent esophagectomy from January 1, 2009, to January 31, 2016, were collected and analyzed. A nomogram was performed using R software (version 4.1.3) based on six risk factors of LNM.

Research results

A total of 474 superficial ESCC patients were enrolled. The prevalence of LNM was 3.29% for intramucosal cancer and increased to 26.40% for submucosal cancer. A nomogram incorporating six variables, including tumor size, invasion depth, tumor differentiation, tumor budding, tumor infiltrative growth pattern, and lymphovascular invasion, was successfully developed.

Research conclusions

We developed a useful nomogram model to predict LNM risk for superficial ESCC patients, which will facilitate additional treatment decisions for patients who underwent endoscopic resection.

Research perspectives

The nomogram model is a simple and useful tool to facilitate the prediction of LNM risk for superficial ESCC patients.