Supraclavicular and/or celiac lymph node metastases from thoracic esophageal squamous cell carcinoma did not compromise survival following neoadjuvant chemoradiotherapy and surgery

Abstract

This study is to evaluate the prognostic significance of supraclavicular and/or celiac lymph node (LN) metastases in locally advanced thoracic esophageal squamous cell carcinoma (ESCC) patients treated with neoadjuvant chemoradiotherapy (NACRT) and surgery. Among the total 199 patients, 75 (37.7%) had supraclavicular and/or celiac LN metastasis. Surgery was performed following NACRT in 168 patients (84.4%). After the median 18.7 (1.0-147.2) months’ follow-up, 2-year rates of progression-free survival (PFS) and overall survival (OS) in all patients were 48.1% and 65.7%, respectively. In multivariate analyses, negative surgical margin (p < 0.001), ypT0 stage (p = 0.004), and ypN0 stage (p = 0.020) were significantly favorable factors for PFS, and negative surgical margin (p < 0.001) was the only significantly favorable factor for OS. Metastasis to the supraclavicular and/or celiac LNs was significant factor neither for PFS (p = 0.311) nor OS (p = 0.515). Supraclavicular and/or celiac LN metastasis did not compromise the clinical outcomes following NACRT and surgery.

Neck Lymph Node Metastasis as A Poor Prognostic Factor in Thoracic Esophageal Squamous Cell Carcinoma Patients Receiving Concurrent Chemoradiotherapy: A Propensity Score-Matched Analysis

“…Several previous studies have revealed that supraclavicular LN metastasis is not an independent prognostic factor for the survival of esophageal cancer patients 13 – 15 . However, the location of supraclavicular LNs is near the area of neck LNs in terms of anatomical distribution.…”

“…In recent years, growing evidence has shown that supraclavicular LN metastasis is not associated with poor prognosis 13 , 14 , 20 , 21 . Cho et al .…”

The prognostic significance of celiac lymph node metastasis in patients with locally advanced esophageal squamous cell carcinoma receiving curative concurrent chemoradiotherapy

“…Recently, several studies found that celiac LN metastasis does not compromise clinical outcomes [ 15 , 17 ]. A Korean study, reported by Cho et al ., showed metastasis to celiac LN was a significant factor neither for PFS nor OS in ESCC patients receiving neoadjuvant chemoradiotherapy and surgery [ 15 ].…”

“…Recently, several studies found that celiac LN metastasis does not compromise clinical outcomes [ 15 , 17 ]. A Korean study, reported by Cho et al ., showed metastasis to celiac LN was a significant factor neither for PFS nor OS in ESCC patients receiving neoadjuvant chemoradiotherapy and surgery [ 15 ]. Another Japanese study, reported by Tachimori et al ., revealed the most predictive factor associated with lymph node metastasis for postoperative survival was not the area of involved nodes, but the number of involved nodes in ESCC patients receiving esophagectomy and three-field LN dissection [ 17 ].…”

“…Furthermore, N stages are subclassified based on the absolute number of positive LNs instead of the presence of regional LN involvement. At the same time, several studies have shown that celiac LN metastasis does not compromise the clinical outcomes of patients who have undergone esophagectomy [ 15 – 17 ]. Moreover, Tachimori et al .…”