AUTHOR=Chen Pingrun , Chen Maojia , Bu Yijie , Che Guowei , Cheng Chao , Wang Yan 

TITLE=Prognostic role of lymph node regression in patients with esophageal cancer undergoing neoadjuvant therapy

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 30 - 2024

YEAR=2024

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2024.1611844

DOI=10.3389/pore.2024.1611844

ISSN=1532-2807

ABSTRACT=Purpose To clarify the prognostic value of lymph node regression (LNR) status including the lymph node regression grade (LNRG) and N downstaging in esophageal cancer patients who receive the neoadjuvant therapy based on available evidence. Methods Several databases were searched up to March 25, 2024. The main outcomes included the overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined.Subgroup analysis based on the neoadjuvant therapy and pathological type were further conducted.Fourteen retrospective studies with 3212 participants were included. Nine and five studies explored the relationship between LNRG and N downstaging and survival, respectively. Pooled results indicated that complete LNR predicted significantly improved OS (HR=0.47, 95% CI: 0.41-0.55, P＜0.001) and DFS (HR=0.42, 95% CI: 0.32-0.55, P ＜ 0.001) and subgroup analysis based on neoadjuvant therapy and pathological type manifested similar results. Besides, N downstaging was also significant related to improved OS (HR=0.40, 95% CI: 0.21-0.77, P=0.006) and CSS (HR=0.27, 95% CI: 0.12-0.60, P＜0.001).LNR could serve as a novel and reliable prognostic factor in esophageal cancer patients receiving neoadjuvant therapy and complete LNR and N downstaging predict better survival.