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. 2021 May 3;16(1):124.
doi: 10.1186/s13019-021-01466-2.

Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

Xuan Liu #  1 , Leilei Wu #  1 , Dongkun Zhang #  2 , Peng Lin  1 , Hao Long  1 , Lanjun Zhang  1 , Guowei Ma  3
Affiliations

Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

Xuan Liu et al. J Cardiothorac Surg. .

Abstract

Background: Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC.

Methods: This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan-Meier analysis and the log-rank test were used to present a classifying effect based on LN status.

Results: LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P < 0.001).

Conclusions: This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

Keywords: Esophageal squamous cell carcinoma; Left gastric artery; Lymph node metastasis; Survival.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of this study
Fig. 2
Fig. 2
Cancer-specific survival of patients based on whether with left gastric artery LN metastasis. Cancer-specific survival curves were used to compare the prognostic significance between the groups with and without left gastric artery metastasis. Kaplan–Meier method, and the log-rank test was used to construct the curves
Fig. 3
Fig. 3
Overall survival among different single station LNM. Overall survival curves were used to explore the prognostic significance of different lymph nodes metastasis. Kaplan–Meier method, and the log-rank test was used to construct the curves. Single station LNM refers to only one lymph node metastasis. P value between left gastric artery LNM and subcarinal LNM is 0.014; P value between left gastric artery LNM and recurrent laryngeal nerve LNM is 0.417; P value between subcarinal LNM and recurrent laryngeal nerve LNM is 0.006
Fig. 4
Fig. 4
Cancer-specific survival in the subgroups on whether with left gastric artery LNM. Cancer-specific survival curves were used to compare the prognostic significance between the groups with and without left gastric artery metastasis. Kaplan–Meier method, and the log-rank test was used to construct the curves. a CSS in subgroups of male; b CSS in subgroups of female; c CSS in subgroups of without postoperative adjuvant therapy; d CSS in subgroups of with postoperative adjuvant therapy; e CSS in subgroups of middle thoracic esophagus; f CSS in subgroups of upper thoracic esophagus; g CSS in subgroups of lower thoracic esophagus; h CSS in subgroups of well differentiation; l CSS in subgroups of moderate differentiation; m CSS in subgroups of poor/un- differentiation
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