Does Pseudo-Lymph Node Skip Metastasis After Neoadjuvant Therapy Affect Esophageal Squamous Cell Carcinoma Outcomes?...

Area of Science:

• Oncology
• Surgical Oncology
• Cancer Metastasis Research

Background:

• Distinguishing lymph node skip metastasis is vital in esophageal squamous cell carcinoma (ESCC) post-neoadjuvant therapy.
• Pseudo-lymph node skip metastasis, unlike classical, involves distal positive nodes despite proximal node response.

Purpose of the Study:

• To evaluate the prognostic significance of pseudo-lymph node skip metastasis in ESCC.
• To differentiate the survival impact of classical versus pseudo-lymph node skip metastasis.

Main Methods:

• A multicenter retrospective analysis of 1030 ESCC patients treated with neoadjuvant therapy and esophagectomy.
• Lymph node skip metastasis classification followed the Japan Esophagus Society staging system.

Main Results:

• Pseudo-lymph node skip metastasis was associated with worse overall and disease-free survival.
• Classical lymph node skip metastasis predicted better disease-free survival.
• Nomograms incorporating skip metastasis status accurately predicted patient outcomes.

Conclusions:

• Clinicians must differentiate classical and pseudo-lymph node skip metastasis due to opposite prognostic implications in ESCC.
• Accurate assessment of lymph node skip metastasis aids personalized treatment strategies and decision-making.