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首页> 外文期刊>Journal of Thoracic Disease >Supraclavicular lymph node metastasis in elderly patients undergoing esophageal squamous cell carcinoma radical surgery: construction of risk and prognostic predictive nomograms
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Supraclavicular lymph node metastasis in elderly patients undergoing esophageal squamous cell carcinoma radical surgery: construction of risk and prognostic predictive nomograms

机译：老年人患者中患者的Supractlavicular淋巴结转移，接受食管鳞状细胞癌自由基手术：风险和预测预测载体的构建

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Background: Supraclavicular lymph node metastasis (SCLN) is an adverse prognostic determinant of esophageal cancer. However, lymphadenectomy for SCLN is a traumatic procedure, especially in elderly patients, which is associated with more postoperative complications. Currently, identification of risk factors of SCLN metastasis and avoidance of unnecessary lymphadenectomy for SCLN in esophageal squamous cell carcinoma (ESCC) patients has become an unmet clinical need. Methods: A total of 90 elderly patients with ESCC between January 2008 and December 2013 was eligible for this analysis. Logistic regression was performed to determine risk factors for SCLN metastasis after ESCC radical surgery in elderly patients. A nomogram was constructed to individually predict the risk for SCLN metastasis. The Kaplan-Meier survival curve and cumulative risk curve were further analyzed to evaluate the effect of SCLN metastasis after ESCC radical surgery on survival prognosis and cumulative risk assessment in elderly patients. Finally, the SCLN metastasis group and the independent risk factor group were fitted by drawing a decision curve to evaluate the net benefit of the model. Results: SCLN developed in 38 patients (42.2%). Postoperative lymph node metastasis (P0.05), tumor thrombus (P0.05) and tumor infiltration (P0.05) were independent risk factors for SCLN metastasis. The influence of SCLN metastasis on postoperative survival in elderly ESCC patients was statistically significant (P=0.028, P 0.05); with the passage of time, the cumulative risk of SCLN metastasis increased, the survival probability decreased, and the survival time was shortened. Conclusions: Postoperative lymph node metastasis, tumor thrombus and tumor infiltration are independent risk factors for recurrence and metastasis of SCLNs in elderly patients with esophageal squamous cell carcinoma. The nomogram model based on these factors provides a preliminary reference for individualized risk assessment, prognosis guidance and decision-making of SCLN metastasis in elderly patients with esophageal squamous cell carcinoma (ESCC).
机译：背景：上丙伐淋巴结转移（SCLN）是食管癌的不良预后决定蛋白。然而，SCLN的淋巴结切除术是一种创伤程序，特别是在老年患者中，与更术后并发症有关。目前，鉴定SCLN转移的危险因素和避免对食管鳞状细胞癌（ESCC）患者的SCLN的不必要的淋巴结切除术已成为未满足的临床需求。方法：2008年1月至2013年1月至2013年12月之间共有90名ESCC患者符合此分析。进行逻辑回归以确定老年患者ESCC根治性手术后SCLN转移的风险因素。构建了一个载体，以单独预测SCLN转移的风险。进一步分析了Kaplan-Meier存活曲线和累积风险曲线，评估了SCLN转移后ESCC根治性外科对老年患者存活预后和累积风险评估的影响。最后，通过绘制决策曲线来评估模型的净利润来拟合SCLN转移组和独立风险因子组。结果：SCLN在38名患者中开发（42.2％）。术后淋巴结转移（P <0.05），肿瘤血栓（P <0.05）和肿瘤浸润（P <0.05）是SCLN转移的独立危险因素。 SCLN转移对老年人ESCC患者术后生存的影响统计学显着（P = 0.028，P <0.05）;随着时间的推移，SCLN转移的累积风险增加，存活率降低，缩短了存活时间。结论：术后淋巴结转移，肿瘤血栓和肿瘤浸润是对老年食管鳞状细胞癌的老年人患者复发和转移的独立危险因素。基于这些因素的载体模型为老年食管鳞状细胞癌（ESCC）的老年人患者的个性化风险评估，预后导引和决策提供了初步参考。

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