Shen Wenbin,Xu Jinrui,Li Shuguang,Li Youmei,Song Chunyang,Zhao Yan,Zhu Shuchai.Effect of logarithmic ratio of positive lymph nodes on the efficacy of different adjuvant treatments for patients with esophageal cancer after surgery[J].Chinese Journal of Radiological Medicine and Protection,2020,40(6):454-460
Effect of logarithmic ratio of positive lymph nodes on the efficacy of different adjuvant treatments for patients with esophageal cancer after surgery
Received:April 19, 2019  
DOI:10.3760/cma.j.issn.0254-5098.2020.06.007
KeyWords:Esophageal neoplasms/esophageal squamous cell carcinoma  Surgical treatment  Positive lymph node log ratio  Adjuvant therapy  Prognosis
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Author NameAffiliationE-mail
Shen Wenbin Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Xu Jinrui Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Li Shuguang Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Li Youmei Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Song Chunyang Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Zhao Yan Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Zhu Shuchai Department of Radiation Oncology, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China sczhu1965@163.com 
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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.
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