Clinical Application
Survival and the value of adjuvant chemotherapy in esophageal squamous cell carcinoma patients with lymphatic metastasis
Qi Zhan, Wang Yuxiang, Yang Qiong, Li Jing, Yao Jifang, He Ming
Published 2017-08-23
Cite as chin j oncol, 2017,39(08): 628-633. DOI: 10.3760/cma.j.issn.0253-3766.2017.08.013
Abstract
ObjectiveTo investigate the prognosis and the value of adjuvant chemotherapy in esophageal squamous cell carcinoma (ESCC) patients with lymphatic metastasis.
MethodsFrom Jan, 2008 to Dec, 2011, 329 patients with ESCC who underwent two-field radical resection(R0), had lymphatic metastasis and survived over three months were enrolled in this study. There were 246 males and 83 females. The median age was 61 years-old. Site of lesion was located at upper- in 23, middle- in 226 and lower-thoracic segment in 80 patients. There were 114 patients treated with surgery alone and 215 patients with adjuvant chemotherapy. Prognostic factors including adjuvant chemotherapy were assessed in ESCC patients with lymphatic metastasis.
ResultsIn 329 ESCC patients with lymphatic metastasis, the 1-, 3-, 5-years overall survival (OS) rate and progress-free survival (PFS) rate were 74.5%, 31.7%, 24.5%, and 55.1%, 27.8%, 24.2%, respectively. Median OS and PFS were 22 and 15 months, respectively. Multivariate analysis showed that, site of lesion and disease stage were independent factors for OS and PFS (P<0.05). Adjuvant chemotherapy was also an independent prognostic factor for OS (P<0.05). Subgroup analysis showed that adjuvant chemotherapy could improve OS mainly in patients of males, ages≤60, tumor length <6 cm, well- or mediated differentiated squamous cell carcinoma, stage pT3, pN2 and ⅢB (P<0.05).
ConclusionsESCC patients with lymphatic metastasis had poor prognosis. Site of lesion and disease stage were important prognositic factors for survival. Adjuvant chemotherapy could improve survival in specific patients.
Key words:
Esophageal neoplasms; Lymph node metastasis; Surgical procedures, operative; Drug therapy; Prognosis
Contributor Information
Qi Zhan
Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
Wang Yuxiang
Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
Yang Qiong
Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
Li Jing
Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
Yao Jifang
Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
He Ming
Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
