Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13313-13320
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13313
Thoracic para-aortic lymph node recurrence in patients with esophageal squamous cell carcinoma: A propensity score-matching analysis
Xu-Yuan Li, Li-Sheng Huang, Shu-Han Yu, Dan Xie
Xu-Yuan Li, Shu-Han Yu, Department of Medical Oncology, Shantou Central Hospital, Shantou 515041, Guangdong Province, China
Li-Sheng Huang, Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Dan Xie, Department of Radiology, Shantou Central Hospital, Shantou 515041, Guangdong Province, China
Author contributions: Li XY and Huang LS contributed equally to this work; Li XY designed the research study; Xie D and Yu SH performed the research; Li XY, Huang LS, Xie D and Yu SH analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: Approval for the use of medical records was obtained from the Ethics Committees of Shantou Central Hospital, China, prior to the study. All study protocols were approved by this committee.
Informed consent statement: Informed consent was waived by the IRB of the Shantou Central Hospital.
Conflict-of-interest statement: All the authors report having no relevant 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: Xu-Yuan Li, MM, Doctor, Department of Medical Oncology, Shantou Central Hospital, No. 114 Waima Road, Shantou 515041, Guangdong Province, China. lxuyuan@qq.com
Received: October 7, 2022
Peer-review started: October 7, 2022
First decision: November 11, 2022
Revised: November 13, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Processing time: 80 Days and 4.6 Hours
Abstract
BACKGROUND

Thoracic para-aortic lymph node (TPLN) recurrence in esophageal squamous cell carcinoma (ESCC) is rare and its impact on survival is unknown. We studied survival in patients with ESCC who developed TPLN recurrence.

AIM

To study the survival in patients with ESCC who developed TPLNs recurrence.

METHODS

Data were collected retrospectively for 219 patients who had undergone curative surgery for ESCC during January 2012 to November 2017 and who developed recurrences (36.29% of 604 patients who had undergone curative surgeries for ESCC). The patients were classified into positive (+) and negative (-) TPLN metastasis subgroups. We also investigated TPLN recurrence in 223 patients with ESCC following definitive chemoradiotherapy during 2012-2013. Following propensity score matching (PSM) and survival estimation, factors predictive of overall survival (OS) were explored using a Cox proportional hazards model.

RESULTS

Among the patients with confirmed recurrence, 18 were TPLN (+) and 13 developed synchronous distant metastases. Before PSM, TPLN (+) was associated with worse recurrence-free (P = 0.00049) and OS [vs TPLN (-); P = 0.0027], whereas only the intergroup difference in recurrence-free survival remained significant after PSM (P = 0.013). The Cox analysis yielded similar results. Among the patients who had received definitive chemoradiotherapy, 3 (1.35%) had preoperative TPLN enlargement and none had developed recurrences.

CONCLUSION

TPLN metastasis is rare but may be associated with poor survival.

Keywords: Esophageal cancer; Surgery; Thoracic para-aortic lymph node; Overall survival; Metastasis

Core Tip: Lymph node recurrence is common in resected esophageal squamous cell carcinoma (ESCC). However, thoracic para-aortic lymph nodes (TPLNs) recurrence in ESCC is rare and its impact on survival is unknown. Our study identified the incidence of TPLNs recurrence in ESCC after curative surgery and revealed TPLNs recurrence negatively associated with the overall survival.