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Prognostic Impact of Thoracic Extra-regional Lymph Node Metastasis Defined By the 12th Japanese Classification
Masahiro Inada1, Kiyoshi Nakamatsu2, Junki Fukuda2
1Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, Japan. im022012@med.kindai.ac.jp.
Purpose:
The aim of this study was to investigate the prognostic impact of thoracic extra-regional lymph node metastasis (M1b-LYM, determined by the 12th edition of the Japanese Classification of Esophageal Cancer) in definitive radiotherapy for esophageal squamous cell carcinoma.
Methods:
Eighty-six consecutive patients who underwent definitive radiotherapy for esophageal squamous cell carcinoma between 2017 and 2022 at our institute were included in this retrospective study. Progression-free survival (PFS), overall survival (OS), distant metastasis (DM), and loco-regional recurrence (LR) were compared between patients with and without M1b-LYM using Kaplan-Meier or cumulative incidence function analysis.
Results:
Among the 86 patients, 15 had M1b-LYM metastasis (the M1b( +) group) and 71 had no M1b-LYM metastasis (the M1b(-) group). The median follow-up period was 38 months. The 2-year PFS, OS, cumulative incidence of DM, and cumulative incidence of LR for the M1b(-) group versus M1b( +) group were 41% vs 20% (p = 0.129), 58% vs 47% (p = 0.172), 31% vs 33% (p = 0.906), and 31% vs 60% (p = 0.0369), respectively. Multivariate analysis showed that M1b( +) was associated with higher LR (p = 0.0350), T stage was associated with poorer PFS (p = 0.0138), and omitting chemotherapy was associated with poorer PFS (p = 0.0160) and OS (p < 0.01).
Conclusion:
The presence of thoracic extra-regional lymph node metastasis was associated with poor loco-regional control but not distant metastasis or survival in esophageal squamous cell carcinoma patients after definitive radiotherapy.
Trial Registration Number:
This study was retrospectively registered on 21 June 2024 (R06-053).
