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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Radiotherapy | Research article

Impacts of neoadjuvant therapy on the number of dissected lymph nodes in esophagogastric junction cancer patients

Authors: Qi Wang, Jin-tong Ge, Hua Wu, Sheng Zhong, Qing-quan Wu

Published in: BMC Gastroenterology | Issue 1/2023

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Abstract

Background

Neoadjuvant therapy favors the prognosis of various cancers, including esophagogastric junction cancer (EGC). However, the impacts of neoadjuvant therapy on the number of dissected lymph nodes (LNs) have not yet been evaluated in EGC.

Methods

We selected EGC patients from the Surveillance, Epidemiology, and End Results (SEER) database (2006–2017). The optimal number of resected LNs was determined using X-tile software. Overall survival (OS) curves were plotted with the Kaplan–Meier method. Prognostic factors were evaluated using univariate and multivariate COX regression analyses.

Results

Neoadjuvant radiotherapy significantly decreased the mean number of LN examination compared to the mean number of patients without neoadjuvant therapy (12.2 vs. 17.5, P = 0.003). The mean LN number of patients with neoadjuvant chemoradiotherapy was 16.3, which was also statistically lower than 17.5 (P = 0.001). In contrast, neoadjuvant chemotherapy caused a significant increase in the number of dissected LNs (21.0, P < 0.001). For patients with neoadjuvant chemotherapy, the optimal cutoff value was 19. Patients with > 19 LNs had a better prognosis than those with 1–19 LNs (P < 0.05). For patients with neoadjuvant chemoradiotherapy, the optimal cutoff value was 9. Patients with  > 9 LNs had a better prognosis than those with 1–9 LNs (P < 0.05).

Conclusions

Neoadjuvant radiotherapy and chemoradiotherapy decreased the number of dissected LNs, while neoadjuvant chemotherapy increased it in EGC patients. Hence, at least 10 LNs should be dissected for neoadjuvant chemoradiotherapy and 20 for neoadjuvant chemotherapy, which could be applied in clinical practice.
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Metadata
Title
Impacts of neoadjuvant therapy on the number of dissected lymph nodes in esophagogastric junction cancer patients
Authors
Qi Wang
Jin-tong Ge
Hua Wu
Sheng Zhong
Qing-quan Wu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02705-7

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