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Lymph-node ratio as a risk factor for recurrence following neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy for locally advanced esophageal squamous cell carcinoma

  • 0Department of Gastroenterological Chemotherapy, Japanese Foundation for Cancer Research, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.
Esophagus : Official Journal of the Japan Esophageal Society +

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January 4, 2025

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January 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The lymph-node ratio (LNR) is a significant predictor of recurrence risk after neoadjuvant chemotherapy (nCT) with docetaxel, cisplatin, and 5-fluorouracil (DCF) for esophageal squamous cell carcinoma (ESCC). A higher LNR indicates a worse prognosis and increased recurrence rates.

Area Of Science

  • Oncology
  • Gastroenterology
  • Surgical Oncology

Background

  • Neoadjuvant chemotherapy (nCT) with docetaxel, cisplatin, and 5-fluorouracil (DCF) is a standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC).
  • The prognostic value of the lymph-node ratio (LNR) after nCT-DCF for ESCC recurrence remains unclear.

Purpose Of The Study

  • To evaluate the clinical utility of the lymph-node ratio (LNR) as a risk factor for recurrence in patients with ESCC treated with nCT-DCF.
  • To determine the association between LNR and disease-free survival (DFS)/recurrence-free survival (RFS) after nCT-DCF and surgery.

Main Methods

  • Retrospective analysis of 75 patients with resectable ESCC who received nCT-DCF followed by curative surgery.
  • Receiver-operating characteristic (ROC) curve analysis was used to determine the optimal cut-off for LNR in predicting recurrence.

Main Results

  • A higher LNR was identified in 45.3% of patients and was associated with significantly worse DFS/RFS (median 8.0 months vs. not reached; P < 0.01).
  • The 1-year DFS/RFS rate was 47.8% for higher LNR and 100% for lower LNR.
  • LNR remained a significant risk factor across various subgroups, including those with non-pathological complete response, positive ypN, or ypStage III.

Conclusions

  • Higher LNR is indicative of a more aggressive tumor phenotype in ESCC patients treated with nCT-DCF.
  • Elevated LNR is associated with worse DFS/RFS rates and increased recurrence risk following nCT-DCF and surgery.

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