Frequency and distribution pattern of lymph node metastasis after neoadjuvant chemoimmunotherapy for locally advanced esophageal squamous cell carcinoma.

IF 2.7 3区医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2024-10-24 DOI:10.1007/s00432-024-05967-0

Hang Zhou, Junpeng Lin, Wenwei Wei, Pengqiang Gao, Pei-Yuan Wang, Shuo-Yan Liu, Feng Wang

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Abstract

Background: Currently, neoadjuvant chemoimmunotherapy (NCIT) is widely used in the perioperative treatment of esophageal squamous cell carcinoma (ESCC). However, the patterns of lymph node metastasis following this novel treatment approach remain poorly understood. The aim of this study was to elucidate the distribution and frequency of postoperative lymph node metastasis (LNM) after NCIT.

Methods: We retrospectively analyzed cases from March 2020 to March 2023 in our hospital and selected patients who underwent NCIT followed by R0 resection for esophageal cancer. A total of 257 patients with clinical stage T3N0 or T1-3N + thoracic esophageal cancer were included. The distribution and frequency of metastatic lesions in each lymph node station were recorded according to the Japan Esophageal Society (JES) staging system. Additionally, we analyzed the patterns of lymph node metastasis based on the location of the thoracic tumor.

Results: Among the 257 patients, 110 (42.8%) had pathologically positive lymph nodes postoperatively. Common sites of lymph node metastasis included station 107 (12.8%), station 106recR (11.7%), and station 7 (12.5%). The lymph node stations with lower metastasis rates were station 105, station 106tbL, and station 111, each with a metastasis rate of 2.3%. In upper thoracic (Ut) cases, station 106recR (23.7%) was the most common site of lymph node metastasis, while in middle thoracic (Mt) cases, station 107 (16.7%) had the highest metastasis rate, and in lower thoracic (Lt) cases, station 7 (17.6%) had the highest metastasis rate. Lymph node metastasis (LNM) was more likely to occur in station 101R in Ut and Mt cases than in Lt cases (13.2% and 8.6%; p < 0.01).

Conclusions: This study reveals the frequency and distribution patterns of lymph node metastasis following NCIT, highlighting the different patterns of lymph node metastasis based on tumor location. These findings can provide guidance for lymph node dissection during surgery.

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局部晚期食管鳞癌新辅助化疗免疫治疗后淋巴结转移的频率和分布模式

背景：目前，新辅助化疗免疫疗法（NCIT）被广泛用于食管鳞状细胞癌（ESCC）的围手术期治疗。然而，人们对这种新型治疗方法的淋巴结转移模式仍然知之甚少。本研究旨在阐明 NCIT 术后淋巴结转移（LNM）的分布和发生频率：我们回顾性分析了我院 2020 年 3 月至 2023 年 3 月的病例，选择了接受 NCIT 后进行 R0 切除术的食管癌患者。共纳入 257 例临床分期为 T3N0 或 T1-3N + 的胸部食管癌患者。根据日本食管学会（JES）的分期系统记录了各淋巴结站转移病灶的分布和频率。此外，我们还根据胸腔肿瘤的位置分析了淋巴结转移的模式：在 257 名患者中，110 人（42.8%）术后病理淋巴结呈阳性。淋巴结转移的常见部位包括 107 站（12.8%）、106recR 站（11.7%）和 7 站（12.5%）。转移率较低的淋巴结部位是 105 站、106tbL 站和 111 站，转移率均为 2.3%。在上胸（Ut）病例中，106recR 站（23.7%）是最常见的淋巴结转移部位，而在中胸（Mt）病例中，107 站（16.7%）的转移率最高，在下胸（Lt）病例中，7 站（17.6%）的转移率最高。在Ut和Mt病例中，101R站的淋巴结转移（LNM）发生率高于Lt病例（分别为13.2%和8.6%；P 结论：本研究揭示了NCIT术后淋巴结转移的频率和分布模式，突出显示了基于肿瘤位置的不同淋巴结转移模式。这些发现可为手术中的淋巴结清扫提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.