Prognostic role of lymph node regression in patients with esophageal cancer undergoing neoadjuvant therapy.

IF 2.3 4区医学 Q3 ONCOLOGY Pathology & Oncology Research Pub Date : 2024-10-11 eCollection Date: 2024-01-01 DOI:10.3389/pore.2024.1611844

Pingrun Chen, Maojia Chen, Yijie Bu, Guowei Che, Chao Cheng, Yan Wang

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Abstract

Purpose: To clarify the prognostic value of lymph node regression (LNR) status including the lymph node regression grade (LNRG) and N downstaging in patients with esophageal cancer receiving neoadjuvant therapy based on available evidence.

Methods: Several databases were searched up to 25 March 2024. The main outcomes included overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined. Subgroup analyses based on the neoadjuvant therapy and pathological type were also conducted.

Results: In total, 14 retrospective studies with 3,212 participants were included. Nine and five studies explored the relationship between LNRG and N downstaging and survival, respectively. Pooled results indicated that complete LNR predicted significantly improved OS (HR = 0.47, 95% CI: 0.41-0.55, P < 0.001) and DFS (HR = 0.42, 95% CI: 0.32-0.55, P < 0.001) and subgroup analysis based on neoadjuvant therapy and pathological type manifested similar results. Besides, N downstaging was also significantly related to improved OS (HR = 0.40, 95% CI: 0.21-0.77, P = 0.006) and CSS (HR = 0.27, 95% CI: 0.12-0.60, P < 0.001).

Conclusion: LNR could serve as a novel and reliable prognostic factor in patients with esophageal cancer receiving neoadjuvant therapy and complete LNR and N downstaging predict better survival.

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接受新辅助治疗的食管癌患者淋巴结消退的预后作用。

目的：根据现有证据，明确接受新辅助治疗的食管癌患者淋巴结消退（LNR）状态（包括淋巴结消退分级（LNRG）和N降级）的预后价值：方法：检索了截至 2024 年 3 月 25 日的多个数据库。主要结果包括总生存期（OS）、无病生存期（DFS）和癌症特异性生存期（CSS）。合并了危险比（HRs）和95%置信区间（CIs）。此外，还根据新辅助疗法和病理类型进行了亚组分析：共有14项回顾性研究纳入了3212名参与者。9项和5项研究分别探讨了LNRG和N降期与生存率之间的关系。汇总结果显示，完全LNR预示着OS（HR=0.47，95% CI：0.41-0.55，P<0.001）和DFS（HR=0.42，95% CI：0.32-0.55，P<0.001）的显著改善，基于新辅助治疗和病理类型的亚组分析也显示出相似的结果。此外，N降期也与OS（HR = 0.40，95% CI：0.21-0.77，P = 0.006）和CSS（HR = 0.27，95% CI：0.12-0.60，P < 0.001）的改善显著相关：LNR可作为接受新辅助治疗的食管癌患者的一个新的、可靠的预后因素，完全LNR和N分期预示着较好的生存率。

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

Pathology & Oncology Research 医学-病理学

CiteScore

6.30

自引率

0.00%

发文量

134

审稿时长

4-8 weeks

期刊介绍： Pathology & Oncology Research (POR) is an interdisciplinary Journal at the interface of pathology and oncology including the preclinical and translational research, diagnostics and therapy. Furthermore, POR is an international forum for the rapid communication of reviews, original research, critical and topical reports with excellence and novelty. Published quarterly, POR is dedicated to keeping scientists informed of developments on the selected biomedical fields bridging the gap between basic research and clinical medicine. It is a special aim for POR to promote pathological and oncological publishing activity of colleagues in the Central and East European region. The journal will be of interest to pathologists, and a broad range of experimental and clinical oncologists, and related experts. POR is supported by an acknowledged international advisory board and the Arányi Fundation for modern pathology.