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

Wei Hsun Chen, Yen Lin Huang, Yin Kai Chao*, Chi Ju Yeh, Hsien Kun Chang, Chen Kan Tseng, Yun Hen Liu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

29 Scopus citations

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.

Original languageEnglish
Pages (from-to)338-343
Number of pages6
JournalAnnals of Surgical Oncology
Volume22
Issue number1
DOIs
StatePublished - 2015

Bibliographical note

Publisher Copyright:
© 2014, Society of Surgical Oncology.

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