Assessment of Lymph Node Ratio to Replace the pN Categories System of Classification of the TNM System in Esophageal Squamous Cell Carcinoma

Shao, Yingjie; Geng, Yiting; Gu, Wenjing; Ning, Zhonghua; Huang, Jin; Pei, Honglei; Jiang, Jingting

doi:10.1016/j.jtho.2016.06.019

Cited by 63 publications

(52 citation statements)

References 31 publications

(52 reference statements)

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“…The ratio of metastatic lymph nodes is affected by the number of examined LNs. Additionally, this study found that the lymph node ratio is an independent predictor of survival in patients undergoing esophagectomy for ESCC, which was consistent with the prior literature 3,4,18 . Lymph node ratio may compensate for de ciencies in the AJCC nodal categories, and combining the lymph node ratio and AJCC nodal categories may more accurately predict survival than the current staging system 19 .…”

Section: Discussionsupporting

confidence: 92%

Predicting Individual Survival After Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

Zhao

Huang

Chen

et al. 2020

Preprint

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Abstract Background Esophageal cancer is one of the leading causes of cancer-related death worldwide 1 . Despite significant progress in the overall treatment of esophageal cancer in recent years, the prognosis for patients who require surgery remains poor. Methods The current paper studied the clinicopathological features of 503 patients who underwent radical esophagectomy at the Huashan Hospital of Fudan University between January 2005 and January 2015. Nomograms which predicted esophageal squamous cell carcinoma (ESCC) survival rates were established using the Cox proportional hazards regression model. Discrimination and calibration, calculated after bootstrapping, were used as a measure of accuracy. Results Multivariate analyses were used to select five independent prognostic variables to build the nomogram. These variables were pathological T stage, pathological N factor, rate of positive LNs, history of chronic obstructive pulmonary disease (COPD) and postoperative sepsis. The nomogram was built to predict the rates of overall survival (OS) and disease-free survival (DFS). The concordance indices of the nomogram prediction of OS and DFS were 0.720 and 0.707, respectively. Compared to the conventional TNM staging system, the nomogram has better predictive accuracy for survival (OS 0.720 vs 0.672, P<0.001; DFS 0.707 vs 0.667, P<0.001). Conclusions The aims of this study were to assess comorbidities and postoperative complications in patients with esophageal cancer and to design a nomogram for the prediction of long-term survival in patients with ESCC. To the best of the knowledge of the authors of this study, this is the first attempt to establish an ESCC nomogram based on comorbidities and postoperative complications using a relatively large cohort of patients.

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Section: Discussionsupporting

confidence: 92%

Predicting Individual Survival After Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

Zhao

Huang

Chen

et al. 2020

Preprint

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“…The inclusion criteria were as follows: ESCC, R0 resection, no other malignant tumor, no lymph node metastasis, no distant metastasis, no radiotherapy and/or chemotherapy before or after surgery. Follow-up was conducted as described previously [ 26 ]. The research agreement was signed according to the guidelines formulated by the Declaration of Helsinki after the approval of the Ethics Committee of the Third People's Hospital of Yanchen.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of nomogram based on lncRNA ZFAS1 for predicting survival in lymph node-negative esophageal squamous cell carcinoma patients

Shi

Liu²,

Dong

et al. 2017

Oncotarget

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BackgroundThere is increasing evidence of a relationship between long non-coding RNA (lncRNA) and cancer. This study aimed to examine the prognostic value of the lncRNA ZFAS1 in esophageal squamous cell carcinoma (ESCC).ResultsThe results showed that ZFAS1 expression was significantly higher in ESCC tissues compared with the corresponding adjacent normal tissues (P < 0.001). ESCC patients with high ZFAS1 expression had a poor overall survival (OS). Histological grade, T stage and ZFAS1 expression were integrated to develop the nomogram. The nomogram showed a significantly better prediction of OS for patients with lymph node-negative ESCC. The ROC curve also showed higher specificity and sensitivity for predicting 3- and 5-year ESCC patient survival compared with the AJCC staging system. The decision curve analysis also indicated a greater potential for the nomogram in clinical application compared with the AJCC staging system. Importantly, our findings were supported by a validation cohort.Materials and MethodsWe retrospectively investigated 398 lymph node-negative ESCC patients. Data from the primary cohort (n = 246) were used to develop a multivariate nomogram. The nomogram was internally validated for discrimination and calibration with bootstrap samples and was externally validated with an independent patient cohort (n = 152).ConclusionsOur proposed nomogram, which integrates clinicopathological factors and ZFAS1 expression, can accurately predict the prognosis of lymph node-negative ESCC patients without preoperative chemoradiotherapy.

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“…In addition to the number of nodes dissected, the extent of mediastinal lymph node dissection is even more important to the outcome of esophagectomy (54)(55)(56). As mentioned earlier, regional lymph node identification and dissection should be based on the understanding of the anatomy of esophageal lymphatic drainage in all 9 stations of mediastinal lymph nodes as defined in the current consensus, and they should be dissected systemically in a radical esophagectomy.…”

Section: Extent Of Thoracic Lymphadenectomy In Radical Surgery For Esmentioning

confidence: 99%

Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition)

Fang

et al. 2018

J. Thorac. Dis.

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Assessment of Lymph Node Ratio to Replace the pN Categories System of Classification of the TNM System in Esophageal Squamous Cell Carcinoma

Abstract: LNR can supplement the pN categorization system for more effective evaluation of prognosis. But the modified staging system based on LNR has a poor clinical practical value for patients with ESCC compared with the current TNM system and is not superior to AJCC pN staging for ESCC.

Cited by 63 publications

References 31 publications

Predicting Individual Survival After Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

Predicting Individual Survival After Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

Development and validation of nomogram based on lncRNA ZFAS1 for predicting survival in lymph node-negative esophageal squamous cell carcinoma patients

Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition)

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