The Impact of Pretreatment PET/CT Nodal Status on Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemoradiation
Journal
World Journal of Surgery
Journal Volume
44
Journal Issue
7
Pages
2323-2331
Date Issued
2020
Author(s)
Abstract
Background: For advanced esophageal cancer, the clinical significance of pretreatment nodal status (cN) as determined by different examinations remains unclear. Patients and methods: Patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiation and surgery were analyzed in this study. Pretreatment cN status assessed by CT, EUS, and PET/CT and clinicopathological features were used to evaluate tumor recurrence and long-term survival. Results: Two hundred and twenty-two patients were identified in this study. Pretreatment PET/CT cN0 [odds ratio (OR) cN0 versus cN+, 5.316, p < 0.001] and pretreatment CT cN0 (OR 1.957, p = 0.032) both independently predicted ypN0. Pretreatment PET/CT cN0 was also associated with a lower recurrence rate and longer survival across the entire study group. Among patients with ypN0, pretreatment PET/CT cN+ indicated poor disease-free survival [hazard ratio (HR) 2.777, p = 0.001] and overall survival (HR 2.211, p = 0.034) compared with pretreatment PET/CT cN0, which predicted a favorable prognosis. Conclusions: Data from the current study suggest that pretreatment lymph node status as assessed by PET/CT is strongly correlated with survival outcomes after neoadjuvant chemoradiation and surgery in patients with esophageal squamous cell carcinoma. ypN0 patients can achieve better survival outcomes when pretreatment cN0 is assessed by PET/CT. ? 2020, Soci?t? Internationale de Chirurgie.
SDGs
Other Subjects
adjuvant chemoradiotherapy; adult; aged; cancer staging; diagnostic imaging; epidemiology; esophageal squamous cell carcinoma; esophagus resection; esophagus tumor; female; follow up; human; lymph node; lymph node metastasis; male; middle aged; mortality; neoadjuvant therapy; pathology; positron emission tomography-computed tomography; prognosis; retrospective study; survival analysis; tumor recurrence; Adult; Aged; Chemoradiotherapy, Adjuvant; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Female; Follow-Up Studies; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prognosis; Retrospective Studies; Survival Analysis
Publisher
Springer
Type
journal article