AI Article Synopsis
- This study focused on the survival outcomes of patients with esophageal squamous cell carcinoma (ESCC) who underwent surgery and how those outcomes are affected by the presence of metastasis to supraclavicular lymph nodes (SCN).
- It analyzed data from 611 patients over 24 years, looking at the differences in overall survival rates between patients with clinically suspicious SCN metastasis and those with pathologically confirmed metastasis.
- Despite initial findings suggesting that SCN metastasis was linked to poorer survival, further analysis indicated that this effect was not significant when considering other factors, concluding that SCN metastasis does not greatly impact overall survival for these patients.
Article Abstract
Background: This study investigated the survival outcomes for surgically treated esophageal squamous cell carcinoma (ESCC) patients based on clinically suspicious supraclavicular lymph node (SCN) metastasis (cSCN+) and pathologically confirmed SCN metastasis (pSCN+).
Methods: Using an institutional registry between 1994 and 2018, this study retrospectively analyzed 611 patients who received curative-intent esophagectomy with 3-field lymph node dissection for ESCC. The study used computed tomography and positron emission tomography to define cSCN+.
Results: Among 611 patients, 24.4% had cSCN+ and 12.2% had pSCN+. The 5-year overall survival (OS) rates were 68.2% for cN0, 43.5% for cN+ without cSCN+, and 30.3% for cN+ with cSCN+ (p = 0.018). Although the univariable analysis showed that cSCN+ was associated with poorer survival than cN0 or cN+ with cSCN- (hazard ratio [HR], 1.818; p < 0.001), the multivariable analysis did not support this finding (HR, 1.281; p = 0.681). The 5-year OS rates were 64.2% for pN0, 41.5% for pN+ without pSCN+, and 25.6% for pN+ with pSCN+ (p = 0.054). Univariable analysis showed an association of pSCN+ with poor OS (HR, 1.830; p < 0.001), but the difference in the multivariable analysis was not significant (HR, 0.912; p = 0.587).
Conclusions: The presence of SCN metastasis did not have a significant impact on the OS of ESCC patients with 3-field lymph node dissection regardless of clinical suspicion or pathologic confirmation.
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| http://dx.doi.org/10.1245/s10434-023-14555-4 | DOI Listing |
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