Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma
Lymphovascular invasion (LVI) is a histopathological feature that is associated with an increased risk for micrometastasis. The aim of this study was to determine the prognostic and staging value of LVI among patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy. A prospec...
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| Veröffentlicht in: | Journal of thoracic oncology 2016-04, Vol.11 (4), p.583-592 |
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| creator | Huang, Qingyuan Luo, Kongjia Chen, Chun Wang, Geng Jin, Jietian Kong, Min Li, Bifeng Liu, Qianwen Li, Jinhui Rong, Tiehua Chen, Haiquan Zhang, Lanjun Chen, Yuping Zhu, Chengchu Zheng, Bin Wen, Jing Zheng, Yuzhen Tan, Zihui Xie, Xiuying Yang, Hong Fu, Jianhua |
| description | Lymphovascular invasion (LVI) is a histopathological feature that is associated with an increased risk for micrometastasis. The aim of this study was to determine the prognostic and staging value of LVI among patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy.
A prospective database of patients with ESCC was used to retrospectively analyze 666 cases to identify the relationship between LVI and survival, and to evaluate predictive accuracy of prognosis after combining LVI and the tumor, node, and metastasis (TNM) system. Pathological slides were reassessed by gastrointestinal pathologists according to the strict criteria; 1000-bootstrap resampling was used for internal validation, and 222 cases from an independent multicenter database were used for external validation.
LVI was present in 33.8% of patients, and the proportion increased with advancing T and N classification. LVI was an independent predictor of unfavorable disease-specific survival (DSS) (hazard ratio = 1.59, 95% confidence interval: 1.30–1.94) and disease-free survival (DFS) (hazard ratio = 1.62, 95% confidence interval: 1.32–1.98) after T classification. Among node-negative patients, LVI and T classification were two independent predictors of DSS and DFS (p < 0.001). The risk score model combing LVI and T classification improved the predictive accuracy of the TNM system for DSS and DFS by 3.5% and 4.8%, respectively (p < 0.001). The external validation showed congruent results. The DSS of TxN0MO disease with LVI was similar to the DSS of TxN1M0 (both p > 0.05). In contrast, LVI was not associated with DSS or DFS among node-positive patients.
The independent prognostic significance of LVI existed only in node-negative patients with ESCC, and the combination of LVI and the TNM system enhanced the predictive accuracy of prognosis. After confirmation, node-negative patients with LVI might be considered for upstaging in pathological staging. |
| doi_str_mv | 10.1016/j.jtho.2015.12.109 |
| format | Article |
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A prospective database of patients with ESCC was used to retrospectively analyze 666 cases to identify the relationship between LVI and survival, and to evaluate predictive accuracy of prognosis after combining LVI and the tumor, node, and metastasis (TNM) system. Pathological slides were reassessed by gastrointestinal pathologists according to the strict criteria; 1000-bootstrap resampling was used for internal validation, and 222 cases from an independent multicenter database were used for external validation.
LVI was present in 33.8% of patients, and the proportion increased with advancing T and N classification. LVI was an independent predictor of unfavorable disease-specific survival (DSS) (hazard ratio = 1.59, 95% confidence interval: 1.30–1.94) and disease-free survival (DFS) (hazard ratio = 1.62, 95% confidence interval: 1.32–1.98) after T classification. Among node-negative patients, LVI and T classification were two independent predictors of DSS and DFS (p < 0.001). The risk score model combing LVI and T classification improved the predictive accuracy of the TNM system for DSS and DFS by 3.5% and 4.8%, respectively (p < 0.001). The external validation showed congruent results. The DSS of TxN0MO disease with LVI was similar to the DSS of TxN1M0 (both p > 0.05). In contrast, LVI was not associated with DSS or DFS among node-positive patients.
The independent prognostic significance of LVI existed only in node-negative patients with ESCC, and the combination of LVI and the TNM system enhanced the predictive accuracy of prognosis. After confirmation, node-negative patients with LVI might be considered for upstaging in pathological staging.</description><identifier>ISSN: 1556-0864</identifier><identifier>EISSN: 1556-1380</identifier><identifier>DOI: 10.1016/j.jtho.2015.12.109</identifier><identifier>PMID: 26792626</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Carcinoma, Squamous Cell - pathology ; Esophageal Neoplasms - pathology ; Esophageal Squamous Cell Carcinoma ; Female ; Humans ; Lymphatic Metastasis ; Lymphovascular invasion ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Retrospective Studies ; Tumor staging</subject><ispartof>Journal of thoracic oncology, 2016-04, Vol.11 (4), p.583-592</ispartof><rights>2016 International Association for the Study of Lung Cancer</rights><rights>Copyright © 2016 by the International Association for the Study of Lung Cancer</rights><rights>Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5115-b0b6c6e338becf07edbc3ab26838096dff84b3bcd003c851f29c81499a9b0af93</citedby><cites>FETCH-LOGICAL-c5115-b0b6c6e338becf07edbc3ab26838096dff84b3bcd003c851f29c81499a9b0af93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26792626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Qingyuan</creatorcontrib><creatorcontrib>Luo, Kongjia</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Wang, Geng</creatorcontrib><creatorcontrib>Jin, Jietian</creatorcontrib><creatorcontrib>Kong, Min</creatorcontrib><creatorcontrib>Li, Bifeng</creatorcontrib><creatorcontrib>Liu, Qianwen</creatorcontrib><creatorcontrib>Li, Jinhui</creatorcontrib><creatorcontrib>Rong, Tiehua</creatorcontrib><creatorcontrib>Chen, Haiquan</creatorcontrib><creatorcontrib>Zhang, Lanjun</creatorcontrib><creatorcontrib>Chen, Yuping</creatorcontrib><creatorcontrib>Zhu, Chengchu</creatorcontrib><creatorcontrib>Zheng, Bin</creatorcontrib><creatorcontrib>Wen, Jing</creatorcontrib><creatorcontrib>Zheng, Yuzhen</creatorcontrib><creatorcontrib>Tan, Zihui</creatorcontrib><creatorcontrib>Xie, Xiuying</creatorcontrib><creatorcontrib>Yang, Hong</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><title>Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma</title><title>Journal of thoracic oncology</title><addtitle>J Thorac Oncol</addtitle><description>Lymphovascular invasion (LVI) is a histopathological feature that is associated with an increased risk for micrometastasis. The aim of this study was to determine the prognostic and staging value of LVI among patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy.
A prospective database of patients with ESCC was used to retrospectively analyze 666 cases to identify the relationship between LVI and survival, and to evaluate predictive accuracy of prognosis after combining LVI and the tumor, node, and metastasis (TNM) system. Pathological slides were reassessed by gastrointestinal pathologists according to the strict criteria; 1000-bootstrap resampling was used for internal validation, and 222 cases from an independent multicenter database were used for external validation.
LVI was present in 33.8% of patients, and the proportion increased with advancing T and N classification. LVI was an independent predictor of unfavorable disease-specific survival (DSS) (hazard ratio = 1.59, 95% confidence interval: 1.30–1.94) and disease-free survival (DFS) (hazard ratio = 1.62, 95% confidence interval: 1.32–1.98) after T classification. Among node-negative patients, LVI and T classification were two independent predictors of DSS and DFS (p < 0.001). The risk score model combing LVI and T classification improved the predictive accuracy of the TNM system for DSS and DFS by 3.5% and 4.8%, respectively (p < 0.001). The external validation showed congruent results. The DSS of TxN0MO disease with LVI was similar to the DSS of TxN1M0 (both p > 0.05). In contrast, LVI was not associated with DSS or DFS among node-positive patients.
The independent prognostic significance of LVI existed only in node-negative patients with ESCC, and the combination of LVI and the TNM system enhanced the predictive accuracy of prognosis. After confirmation, node-negative patients with LVI might be considered for upstaging in pathological staging.</description><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Squamous Cell Carcinoma</subject><subject>Female</subject><subject>Humans</subject><subject>Lymphatic Metastasis</subject><subject>Lymphovascular invasion</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Tumor staging</subject><issn>1556-0864</issn><issn>1556-1380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcGO0zAUtBCIXQo_wAH5yCVd20ncWOKCql2oVC1IC1wtx35pXBK7aztd7Vfwy7ibLkcOlp-fZkbjGYTeU7KkhPKr_XKfer9khNZLyvJOvECXtK55QcuGvDzPpOHVBXoT456QqiZV8xpdML4SjDN-if5sDLhkO6tVst5h5Qz-pQZr5qfv8PZxPPT-qKKeBhXwxuXxCRmxwt-D3zkfk9VPzLukdtbt8I3SyQdsHb71Bopb2GW5I-Dr6A-92oEa8N39pEY_RbyGYcBrFbR1flRv0atODRHene8F-nlz_WP9tdh--7JZf94Wuqa0LlrScs2hLJsWdEdWYFpdqpbxJv9ccNN1TdWWrTaElLqpaceEbmglhBItUZ0oF-jjrHsI_n6CmORoo85WlIPsStLVinMmyiy4QGyG6uBjDNDJQ7CjCo-SEnkqQu7lqQh5KkJSlncn_Q9n_akdwfyjPCefAdUMePBDghB_D9MDBNnnbFIvCWVV2YiqyJqcVISQIh9aZ9qnmQY5nKPNjKgtOA3GBtBJGm__Z-sv4j-sIQ</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Huang, Qingyuan</creator><creator>Luo, Kongjia</creator><creator>Chen, Chun</creator><creator>Wang, Geng</creator><creator>Jin, Jietian</creator><creator>Kong, Min</creator><creator>Li, Bifeng</creator><creator>Liu, Qianwen</creator><creator>Li, Jinhui</creator><creator>Rong, Tiehua</creator><creator>Chen, Haiquan</creator><creator>Zhang, Lanjun</creator><creator>Chen, Yuping</creator><creator>Zhu, Chengchu</creator><creator>Zheng, Bin</creator><creator>Wen, Jing</creator><creator>Zheng, Yuzhen</creator><creator>Tan, Zihui</creator><creator>Xie, Xiuying</creator><creator>Yang, Hong</creator><creator>Fu, Jianhua</creator><general>Elsevier Inc</general><general>Copyright by the International Association for the Study of Lung Cancer</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma</title><author>Huang, Qingyuan ; Luo, Kongjia ; Chen, Chun ; Wang, Geng ; Jin, Jietian ; Kong, Min ; Li, Bifeng ; Liu, Qianwen ; Li, Jinhui ; Rong, Tiehua ; Chen, Haiquan ; Zhang, Lanjun ; Chen, Yuping ; Zhu, Chengchu ; Zheng, Bin ; Wen, Jing ; Zheng, Yuzhen ; Tan, Zihui ; Xie, Xiuying ; Yang, Hong ; Fu, Jianhua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5115-b0b6c6e338becf07edbc3ab26838096dff84b3bcd003c851f29c81499a9b0af93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Squamous Cell Carcinoma</topic><topic>Female</topic><topic>Humans</topic><topic>Lymphatic Metastasis</topic><topic>Lymphovascular invasion</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Tumor staging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Qingyuan</creatorcontrib><creatorcontrib>Luo, Kongjia</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Wang, Geng</creatorcontrib><creatorcontrib>Jin, Jietian</creatorcontrib><creatorcontrib>Kong, Min</creatorcontrib><creatorcontrib>Li, Bifeng</creatorcontrib><creatorcontrib>Liu, Qianwen</creatorcontrib><creatorcontrib>Li, Jinhui</creatorcontrib><creatorcontrib>Rong, Tiehua</creatorcontrib><creatorcontrib>Chen, Haiquan</creatorcontrib><creatorcontrib>Zhang, Lanjun</creatorcontrib><creatorcontrib>Chen, Yuping</creatorcontrib><creatorcontrib>Zhu, Chengchu</creatorcontrib><creatorcontrib>Zheng, Bin</creatorcontrib><creatorcontrib>Wen, Jing</creatorcontrib><creatorcontrib>Zheng, Yuzhen</creatorcontrib><creatorcontrib>Tan, Zihui</creatorcontrib><creatorcontrib>Xie, Xiuying</creatorcontrib><creatorcontrib>Yang, Hong</creatorcontrib><creatorcontrib>Fu, Jianhua</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thoracic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Qingyuan</au><au>Luo, Kongjia</au><au>Chen, Chun</au><au>Wang, Geng</au><au>Jin, Jietian</au><au>Kong, Min</au><au>Li, Bifeng</au><au>Liu, Qianwen</au><au>Li, Jinhui</au><au>Rong, Tiehua</au><au>Chen, Haiquan</au><au>Zhang, Lanjun</au><au>Chen, Yuping</au><au>Zhu, Chengchu</au><au>Zheng, Bin</au><au>Wen, Jing</au><au>Zheng, Yuzhen</au><au>Tan, Zihui</au><au>Xie, Xiuying</au><au>Yang, Hong</au><au>Fu, Jianhua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma</atitle><jtitle>Journal of thoracic oncology</jtitle><addtitle>J Thorac Oncol</addtitle><date>2016-04</date><risdate>2016</risdate><volume>11</volume><issue>4</issue><spage>583</spage><epage>592</epage><pages>583-592</pages><issn>1556-0864</issn><eissn>1556-1380</eissn><abstract>Lymphovascular invasion (LVI) is a histopathological feature that is associated with an increased risk for micrometastasis. The aim of this study was to determine the prognostic and staging value of LVI among patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy.
A prospective database of patients with ESCC was used to retrospectively analyze 666 cases to identify the relationship between LVI and survival, and to evaluate predictive accuracy of prognosis after combining LVI and the tumor, node, and metastasis (TNM) system. Pathological slides were reassessed by gastrointestinal pathologists according to the strict criteria; 1000-bootstrap resampling was used for internal validation, and 222 cases from an independent multicenter database were used for external validation.
LVI was present in 33.8% of patients, and the proportion increased with advancing T and N classification. LVI was an independent predictor of unfavorable disease-specific survival (DSS) (hazard ratio = 1.59, 95% confidence interval: 1.30–1.94) and disease-free survival (DFS) (hazard ratio = 1.62, 95% confidence interval: 1.32–1.98) after T classification. Among node-negative patients, LVI and T classification were two independent predictors of DSS and DFS (p < 0.001). The risk score model combing LVI and T classification improved the predictive accuracy of the TNM system for DSS and DFS by 3.5% and 4.8%, respectively (p < 0.001). The external validation showed congruent results. The DSS of TxN0MO disease with LVI was similar to the DSS of TxN1M0 (both p > 0.05). In contrast, LVI was not associated with DSS or DFS among node-positive patients.
The independent prognostic significance of LVI existed only in node-negative patients with ESCC, and the combination of LVI and the TNM system enhanced the predictive accuracy of prognosis. After confirmation, node-negative patients with LVI might be considered for upstaging in pathological staging.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26792626</pmid><doi>10.1016/j.jtho.2015.12.109</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Carcinoma, Squamous Cell - pathology Esophageal Neoplasms - pathology Esophageal Squamous Cell Carcinoma Female Humans Lymphatic Metastasis Lymphovascular invasion Male Middle Aged Neoplasm Invasiveness Neoplasm Staging Prognosis Prospective Studies Retrospective Studies Tumor staging |
| title | Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma |
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