Objective To evaluate the role of the log odds of positive lymph nodes (LODDS) in predicting the long-term prognosis of patients with thoracic esophageal squamous cell carcinoma (TESCC).

Methods We retrospectively analyzed the clinical data of 731 TESCC patients after radical surgery and the prognostic value of LODDS in the whole group of patients, postoperative lymph node-negative (pN0) patients and patients with the number of intraoperative lymph nodes dissected < 12.

Results LODDS was significantly correlated with the number of positive lymph nodes and the number of intraoperative lymph nodes dissected (r=0.696, -0.530, all P=0.000). ROC curve analysis showed that the optimal cut-off point of LODDS was -1.028. Multivariate analysis showed that gender, age, location of esophageal lesions, pT stage, number of positive lymph nodes and LODDS value were independent factors for the survival of the whole group and the OS of the patients with the number of intraoperative lymph nodes dissected≥12 (P < 0.05). Gender, age, location of esophageal lesions, pT stage and LODDS value were independent factors affecting the survival of pN0 patients after operation (P < 0.05). pT stage and LODDS value were independent factors affecting the OS of the patients with the number of intraoperative lymph nodes dissected < 12 (P < 0.05).

Conclusion LODDS could be used as an independent prognostic index for the patients with different TESCC after radical surgery.