Prognostic impact of recurrent laryngeal nerve lymph node metastatic status in thoracic esophageal squamous cell carcinoma.

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-05-03 DOI:10.1093/dote/doaf052

Pengjie Yang, Bing Xue, Tianlai Liu, Lin Qi, Qiang Guo, Ting Yang, Mengfei Sun, Yongjun Yu, Bater Han, Yong Li

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引用次数: 0

Abstract

Esophageal squamous cell carcinoma (ESCC) is a highly aggressive malignancy with poor prognosis, and lymph node metastasis significantly influences patient outcomes. This retrospective study analyzed 189 thoracic ESCC patients who underwent radical esophagectomy (2019-2021) to evaluate the prognostic role of recurrent laryngeal nerve lymph node metastasis (RLN LNM). Patients with RLN LNM showed significantly worse overall survival (OS, P = 0.01) and disease-free survival (DFS, P = 0.046) than those without metastasis, with a 50.53% higher mortality risk and 37.83% higher recurrence risk. Subgroup analysis revealed no survival differences between left- and right-sided RLN LNM (P>0.05), while bilateral RLN LNM trended toward poorer outcomes but without statistical significance. Patients with RLN LNM plus extranodal metastases had markedly reduced OS (P = 0.0014) and DFS (P = 0.0008) compared to isolated RLN LNM. RLN LNM significantly predicted poor prognosis in lower thoracic ESCC (OS: P = 0.0027; DFS: P = 0.037) but not in upper or middle thoracic tumors. Multivariate Cox regression identified RLN LNM, perineural invasion, lymphovascular invasion, and neoadjuvant chemoradiotherapy with immunotherapy as independent risk factors for OS. These findings highlight RLN LNM as a critical prognostic indicator, particularly for lower thoracic ESCC, and emphasize the importance of integrating RLN LNM status into treatment strategies and staging systems.

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胸段食管鳞状细胞癌喉返神经淋巴结转移状况对预后的影响。

食管鳞状细胞癌（ESCC）是一种预后差的高侵袭性恶性肿瘤，淋巴结转移对患者预后有显著影响。本回顾性研究分析了189例接受根治性食管切除术的胸段ESCC患者（2019-2021），以评估喉返神经淋巴结转移（RLN LNM）对预后的影响。RLN LNM患者的总生存期（OS, P = 0.01）和无病生存期（DFS, P = 0.046）明显低于无转移患者，死亡风险高50.53%，复发风险高37.83%。亚组分析显示，左右侧RLN LNM生存率无差异（P < 0.05），而双侧RLN LNM预后较差，但无统计学意义。与单独的RLN LNM相比，RLN LNM合并结外转移的患者的OS （P = 0.0014）和DFS （P = 0.0008）显着降低。RLN LNM显著预测下胸ESCC预后不良(OS: P = 0.0027；DFS: P = 0.037)，但胸椎上段和中段肿瘤无明显差异。多因素Cox回归发现，RLN、LNM、神经周围浸润、淋巴血管浸润和新辅助放化疗联合免疫治疗是OS的独立危险因素。这些发现强调了RLN LNM是一个关键的预后指标，特别是对于下胸ESCC，并强调了将RLN LNM状态纳入治疗策略和分期系统的重要性。

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来源期刊

Diseases of the Esophagus Medicine-Gastroenterology

自引率

7.70%

发文量

568

期刊介绍： Diseases of the Esophagus covers all aspects of the esophagus - etiology, investigation and diagnosis, and both medical and surgical treatment.