Scholarlink

Background <p>Esophageal squamous cell carcinoma (ESCC) is an aggressive malignancy with poor prognosis. Accurate lymph node (LN) staging is vital for prognostication. This study compared accuracy of&#xa0;5 LN staging systems for predicting long- and short-term outcomes.</p> Methods <p>An ambispective cohort study included 1803 ESCC patients who underwent esophagectomy between January 2015 and December 2016, with follow-up until July 2022. Long-term outcomes were overall survival (OS) and disease-free survival (DFS). Short-term outcomes included postoperative complications. Kaplan–Meier and log-rank tests compared survival, Cox regression assessed OS/DFS, and logistic regression analyzed complications. Prognostic accuracy was compared using Akaike Information Criterion (AIC), concordance index (C-index), and area under the curve (AUC).</p> Results <p>Cox regression analysis demonstrated that pN (HR = 4.583, 95% CI 3.412–6.155), lymph node ratio (LNR) (HR = 5.234, 95% CI 3.936–6.950), log odds of positive lymph nodes (LODDS) (HR = 3.236, 95% CI 2.678–3.910), negative lymph nodes (HR = 0.686, 95% CI 0.560–0.840), and resected lymph nodes (HR = 0.791, 95% CI 0.637–0.980) were associated with OS in ESCC patients, with consistent findings observed for DFS. pN, LNR, and LODDS were associated with postoperative complications. LNR had the best long-term prognostic performance (5-year OS AUC = 0.791, 5-year&#xa0;DFS AUC = 0.766), while LODDS was superior for predicting short-term outcomes (AUC = 0.731).</p> Conclusion <p>LNR was the most accurate staging system&#xa0;for long-term prognosis, and LODDS best predicted short-term outcomes in ESCC. These findings may refine LN staging and prognostication in ESCC.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic impact of different lymph node staging systems in patients with esophageal squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2025年11月22日

查看全文
  • Peinan Chen,
  • Tongtong Ren,
  • Yishuo Gao,
  • Ning Wu,
  • Qi Liu,
  • Xiaocan Jia,
  • Yongkui Yu

摘要

Background

Esophageal squamous cell carcinoma (ESCC) is an aggressive malignancy with poor prognosis. Accurate lymph node (LN) staging is vital for prognostication. This study compared accuracy of 5 LN staging systems for predicting long- and short-term outcomes.

Methods

An ambispective cohort study included 1803 ESCC patients who underwent esophagectomy between January 2015 and December 2016, with follow-up until July 2022. Long-term outcomes were overall survival (OS) and disease-free survival (DFS). Short-term outcomes included postoperative complications. Kaplan–Meier and log-rank tests compared survival, Cox regression assessed OS/DFS, and logistic regression analyzed complications. Prognostic accuracy was compared using Akaike Information Criterion (AIC), concordance index (C-index), and area under the curve (AUC).

Results

Cox regression analysis demonstrated that pN (HR = 4.583, 95% CI 3.412–6.155), lymph node ratio (LNR) (HR = 5.234, 95% CI 3.936–6.950), log odds of positive lymph nodes (LODDS) (HR = 3.236, 95% CI 2.678–3.910), negative lymph nodes (HR = 0.686, 95% CI 0.560–0.840), and resected lymph nodes (HR = 0.791, 95% CI 0.637–0.980) were associated with OS in ESCC patients, with consistent findings observed for DFS. pN, LNR, and LODDS were associated with postoperative complications. LNR had the best long-term prognostic performance (5-year OS AUC = 0.791, 5-year DFS AUC = 0.766), while LODDS was superior for predicting short-term outcomes (AUC = 0.731).

Conclusion

LNR was the most accurate staging system for long-term prognosis, and LODDS best predicted short-term outcomes in ESCC. These findings may refine LN staging and prognostication in ESCC.

Graphical abstract