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Prognostic Significance of Lymphovascular Invasion in Patients with Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

To investigate the prognostic significance of lymphovascular invasion (LVI) in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT).

Methods

We retrospectively reviewed the charts of 416 consecutive patients with ESCC who underwent surgical resection following nCRT at the Chang Gung Memorial Hospital between 1998 and 2008. After exclusion of patients with non-R0 resection or showing no residual tumor (ypT0Nx), the histological tumor sections of 231 patients were reviewed for LVI. Univariate and multivariate analyses were used to identify the independent predictors of overall survival (OS).

Results

LVI was observed in 85 patients (36.8 %). The presence of LVI was related to close circumferential resection margins (CRMs), a greater depth of invasion, poor tumor differentiation, and an increased occurrence of lymph node metastases (LNM). The 5 year OS was significantly lower (10 %) in patients with LVI than in those without (31 %; p < 0.001). By multivariate Cox regression analyses, LVI (hazard ratio [HR] 1.5; p = 0.002) and LNM (HR 1.6; p = 0.007) were identified as independent adverse prognostic factors for OS. The 5 year OS rates according to the number of risk factors present were 35, 21, 20, and 5 for LVI(−)LNM(−), LVI(+)LNM(−), LVI(−)LNM(+), and LVI(+)LNM(+) patients, respectively (p < 0.001).

Conclusions

The presence of LVI is independently associated with shorter OS in ESCC patients receiving nCRT. Links between LVI and LNM may provide new clues for the prognostic stratification of esophageal cancer.

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Acknowledgments

This study was partly supported by Grants NSC101-2314-B-182-094-MY2 (from the National Science Council, Executive Yuan, Taiwan, Republic of China) and NMRPD1B1432 (from the Chang Gung Memorial Hospital, Taiwan, Republic of China).

Conflicts of interest

None.

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Authors and Affiliations

  1. Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Wei-Hsun Chen MD, Yin-Kai Chao MD, PhD & Yun-Hen Liu MD

  2. Department of Pathology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Yen-Lin Huang MD & Chi-Ju Yeh MD

  3. Division of Hematology/Oncology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Hsien-Kun Chang MD

  4. Department of Radiation Oncology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chen-Kan Tseng MD

Authors
  1. Wei-Hsun Chen MD
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  2. Yen-Lin Huang MD
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  3. Yin-Kai Chao MD, PhD
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  4. Chi-Ju Yeh MD
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  5. Hsien-Kun Chang MD
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  6. Chen-Kan Tseng MD
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  7. Yun-Hen Liu MD
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Corresponding author

Correspondence to Yin-Kai Chao MD, PhD.

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Chen, WH., Huang, YL., Chao, YK. et al. Prognostic Significance of Lymphovascular Invasion in Patients with Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy. Ann Surg Oncol 22, 338–343 (2015). https://doi.org/10.1245/s10434-014-3881-5

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  • DOI: https://doi.org/10.1245/s10434-014-3881-5

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