Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer

摘要

A negative lymph node (NLN) may represent a stronger predictor for the overall survival (OS) rate of patients with esophageal squamous cell carcinoma (ESCC), when compared with a positive LN (PLN). The present study aimed to investigate which LN station, containing the NLN, was associated with OS rate. A retrospective review was conducted in 216 patients with ESCC and a forward stepwise Cox regression model analysis was used to assess the relationship between clinical parameters and OS rate. Patients were divided into subgroups according to the status of the LN at station 108. Survival analysis was performed using the Kaplan-Meier method. The ratio of albumin-to-globulin (AGR), and of lymphocytes to neutrophil granulocytes (LNR) in the subgroups were also investigated. Overall, 105p (the PLN number at station 105), 108p, 109p and 7p were confirmed to be risk factors for OS rate (all P<0.05). Conversely, 108n (the NLN number at station 108) was identified as a protective factor for OS rate [hazard ratio (HR) 0.457, P=0.001]. Survival analysis demonstrated that patients with an NLN identified at the station 108 had an improved OS rate compared with those with a PLN identified at station 108 (P=0.006). Patients with only an NLN identified at station 108 had the best OS rate among all the sub-groups examined, and the AGR of this group of patients was higher than those of the other groups. The LN status at station 108 may indicate the prognosis of patients with ESCC, and an NLN may reflect the reaction of the immune system to tumor metastasis in these patients.