Lymph node ratio predicts adjuvant chemotherapy benefit in esophageal squamous cell carcinoma.

IF 4.2 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-10-01 DOI:10.1093/oncolo/oyaf315

Jun Peng, Yi Wang, Haoyue Hu, Lei Wu, Wei Dai, Yehan Zhou, Na Li, Lin Peng, Xuefeng Leng, Xiang Zhuang, Qifeng Wang, Xiang Wang

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引用次数: 0

Abstract

Background: The lymph node ratio (LNR) has emerged as an important prognostic factor in various cancers, including esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the utility of LNR in guiding decisions for adjuvant chemotherapy in ESCC patients following resection.

Materials and methods: A retrospective analysis was conducted on 2267 patients who underwent potentially curative surgery for ESCC at Sichuan Cancer Hospital and Institute between January 2010 and December 2017. Univariate and multivariate Cox proportional hazards regressions were used to assess factors influencing overall survival (OS), with LNR analyzed using restricted cubic splines (RCS) to explore its relationship with treatment and survival outcomes. Propensity score matching (PSM) was employed to adjust for biases between treatment groups.

Results: Among the patients, 1416 underwent surgery alone (S group) and 851 received surgery plus adjuvant chemotherapy (S + CT group). The median LNR was 3%, with an interquartile range of 0%-12%. RCS analysis identified an LNR threshold of 11%, below which patients showed a significant OS benefit from adjuvant chemotherapy (hazard ratio [HR]: 0.57; 95% CI: 0.46-0.71; P < 0.001). However, patients with an LNR above 11% did not derive any OS benefit from chemotherapy (HR: 0.87; 95% CI: 0.70-1.09; P = 0.238).

Conclusion: These findings suggest that LNR is a valuable marker for identifying ESCC patients who would benefit from postoperative adjuvant chemotherapy. A threshold LNR of 11% can help personalize treatment strategies, and patients with higher LNRs may require more intensive approaches like chemoradiotherapy to improve survival. Further prospective studies are needed to validate these results.

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淋巴结比例预测食管鳞状细胞癌的辅助化疗效果。

背景：淋巴结比例（LNR）已成为包括食管鳞状细胞癌（ESCC）在内的各种癌症的重要预后因素。本研究旨在评估LNR在ESCC患者术后辅助化疗决策中的指导作用。材料与方法：回顾性分析2010年1月至2017年12月在四川省肿瘤医院和肿瘤研究所接受有治愈潜力的ESCC手术的2267例患者。使用单因素和多因素Cox比例风险回归来评估影响总生存期（OS）的因素，并使用限制性三次样条（RCS）分析LNR，以探讨其与治疗和生存结局的关系。采用倾向评分匹配（PSM）来校正治疗组间的偏倚。结果：单纯手术1416例（S组），手术加辅助化疗851例（S+CT组）。LNR中位数为3%，四分位数范围为0-12%。RCS分析发现LNR阈值为11%，低于该阈值的患者从辅助化疗中获得显著的OS获益（HR 0.57; 95% CI 0.46-0.71; p）。结论：这些发现表明LNR是鉴别ESCC患者是否从术后辅助化疗中获益的一个有价值的指标。阈值LNR为11%有助于个性化治疗策略，LNR较高的患者可能需要更强化的方法，如放化疗，以提高生存率。需要进一步的前瞻性研究来验证这些结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.