Impact of Lymph Node Ratio on Prognosis of Patients with Esophageal Cancer

Objective：To assess the impact of lymph node ratio (LNR) on prognosis for esophageal cancer (EC) patients undergoing standard lymphadenectomy. Methods ：Data including demographic, clinicopathological factors and prognostic outcome of EC patients were collected retrospectively.Kaplan-Meier curves and Cox regression analysis were used to evaluate the association between survival and these factors. Results ：Of 1758 LNs yielded from 245 cases, 220 LNs were identified positive from 112 pN1 patients by pathological examination.So LN metastasis rate was 45.71% and LNR was 0.13 to the total cohort.There was a statistically significant benefit in the 5-year survival rate for patients with more radical esophagectomy, nodal negative or lower of LNR characteristics (P<0.05).After adjusting for potential confounders, multivariate Cox regression analysis revealed histological type, residual tumor status, depth of invasion, LN status and LNR could predict as independent prognostic factors (P<0.05). Conclusion ：Number of involved lymph node can not predict survival based on our data, while LNR was more sensitive reflecting prognosis in standard lymphadenectomy during esophagectomy.