Effect of logarithmic ratio of positive lymph nodes on the efficacy of different adjuvant treatments for patients with esophageal cancer after surgery / 中华放射医学与防护杂志

ABSTRACT

Objective:To analyze the effect of positive lymph node log ratio (LODDS) on the prognosis of postoperative patients with esophageal cancer, and analyze the effect of LODDS on the evaluation of the efficacy of patients receiving different postoperative adjuvant treatment.Methods:A total of 1 546 patients with esophageal cancer treated in the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The effect of LODDS on the prognosis of patients was retrospectively analyzed. The significance of LODDS in choosing different treatment options for patients after operation was further analyzed.Results:The 1-, 3- and 5-year survival rates were 87.5%, 61.7% and 52.2%, respectively. The result of area under curve(ROC)curve analysis show that -1.354 1 is the best cut-off point for LODDS. Multivariate analysis showed that gender, age, lesion location, degree of adhesion, adjuvant therapy, pTNM stage and LODDS were the independent factors affecting the patients ( P<0.05). After propensity-matched analysis(PSM)analysis, there were 205 patients in each group. Multivariate analysis showed that gender, degree of adhesion, adjuvant therapy, pTNM stage and LODDS were independent prognostic factors ( P<0.05). The result of stratified analysis showed that patients with small LODDS values had better prognosis (OS) in patients undergoing postoperative adjuvant therapy than patients in the surgery alone ( χ2=81.470, 5.182, P<0.05), but postoperative chemotherapy (POCT) and postoperative radiotherapy and chemotherapy (POCRT) had no significant difference in the OS of patients ( P>0.05). However, in the larger LODDS group, the OS of patients in the POCRT group was significantly better than the other two groups ( χ2=4.151, 24.020, P<0.05), and there was also a significant difference between the POCT and POCRT groups ( χ2=8.728, P<0.05). Conclusions:LODDS is an independent prognostic factor for postoperative patients with esophageal squamous cell carcinoma and can guide the choice of postoperative adjuvant therapy to a certain extent. This conclusion needs further clinical research to confirm.