Analysis of the lymph node metastasis and prognostic risk factors of stage T1b esophageal squamous cell carcinoma

ObjectiveTo explore the risk factors and prognostic independent risk factors of lymph node metastasis in stage T1b esophageal squamous cell carcinoma patients.

MethodsThe clinical data of 140 stage T1b esophageal squamous cell carcinoma patients treated with radical surgery combined with lymph node dissection were retrospectively analyzed.The patients were divided into the lymph node positive group and lymph node negative group according to the postoperative pathological results, and the lymph node metastasis and prognostic factors in two groups were analyzed.

ResultsAmong 140 patients, there were 20 cases in the lymph node positive group and 120 cases in the lymph node negative group, and the lymph node metastasis rate was 14.3%.The results of univariate analysis showed that the differences of the age, tumor differentiation and tumor diameter between two groups were statistically significant(P < 0.05).The results of multivariate analysis showed that the age ≥55 years, medium and low differentiation and tumor diameter ≥5 cm were the independent risk factors of lymph node metastasis(P < 0.05 to P < 0.01).During 58(3-127) months of following-up, 9 cases were lost to follow-up and 15 cases died, and the survival rate was 98.2%.The 3-year and 5-year survival rates in the stage T1b lymph node positive group and negative group were 84.7% & 73.3% and 98.2% & 96.9%, respectively.The survival rate in lymph node positive group was significantly lower than that in lymph node negative group(P < 0.01).The results of COX multivariate analysis showed that the lymph node metastasis and female were the independent risk factors of prognosis of stage T1b esophageal squamous cell carcinoma patients(P < 0.05 and P < 0.01).

ConclusionsThe age≥55 years, moderate and low differentiation and tumor diameter ≥5 cm are the high-risk independent factors of lymph node metastasis in patients with stage T1b esophageal squamous cell carcinoma.Lymph node metastasis and female are the independent risk factors of prognosis of patients with stage T1b esophageal squamous cell carcinoma.