Lymph Node Ratio Is an Independent Prognostic Factor for Patients with Siewert Type II Adenocarcinoma of Esophagogastric
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ORIGINAL RESEARCH
Lymph Node Ratio Is an Independent Prognostic Factor for Patients with Siewert Type II Adenocarcinoma of Esophagogastric Junction: Results from a 10-Year Follow-up Study Yuling Zhang 1 & Ditian Liu 2 & De Zeng 3,4
&
Chunfa Chen 5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Emerging evidences suggest that lymph node ratio (LNR), the number of metastatic lymph node (LN) to the total number of dissected lymph nodes (NDLN), may predict survival in multiple types of solid tumor. However, the prognostic role of LNR in adenocarcinoma of the esophagogastric junction (AEG) remains uninvestigated. The present study is intended to determine the prognostic value of LNR in the patients with Siewert type II AEG. Methods A total of 342 patients with Siewert type II AEG who underwent R0 resection were enrolled in this study. The optimal cutoff of LNR was stratified into tertiles using X-tile software. The log-rank test was used to evaluate the survival differences, and multivariate Cox regression analyses were performed to determine the independent prognostic variables. Results The optimal cutoff of LNR were classified as LNR = 0, LNR between 0.01 and 0.40, and LNR > 0.41. Patients with high LNR had a shorter 5- and 10-year disease-specific survival (DSS) rate (8.5%, 1.4%) compared with those with moderate LNR (20.4%, 4.9%) and low LNR (58.0%, 27.5%) (P < 0.001). Multivariate Cox regression analysis indicated that LNR was an independent factor for DSS after adjusting for confounding variables (P < 0.05). Furthermore, after stratification by NDLN between NDLN < 15 group and NDLN ≥ 15 group, the LNR remained a significant predictor for DSS (P < 0.05). Conclusions LNR is an independent predictor for DSS in patients with Siewert type II AEG regardless of NDLN. Patients with higher LNR have significantly shorter DSS. Keywords Adenocarcinoma of the esophagogastric junction . Lymph node ratio . Number of dissected lymph nodes . Prognosis
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12029-020-00468-y) contains supplementary material, which is available to authorized users. * De Zeng [email protected] * Chunfa Chen [email protected] 1
Department of Medical Information, Shantou University Medical College Cancer Hospital, Shantou, China
2
Department of Thoracic Surgery, Shantou University Medical College Cancer Hospital, Shantou, China
3
Department of Medical Oncology, Shantou University Medical College Cancer Hospital, Shantou, China
4
Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Shantou, China
5
The Breast Centre, Shantou University Medical College Cancer Hospital, Shantou, China
The morbidities of esophagogastric junction carcinoma (EGJ) have dramatically increased in recent decades [1–3]. EGJ is characterized by pathologically heterogeneous tumors developing in the border between the esophageal squamous epithelium and gastric adenomatous epithelium, and includes c
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