ObjectiveTo evaluate whether three preoperative nutritional scoring indices, the Naples prognostic score (NPS), controlling nutritional status (CONUT), and prognostic nutritional index (PNI), are associated with the clinicopathological characteristics and prognosis of patients with esophageal squamous cell carcinoma (ESCC). MethodsA retrospective analysis was conducted on clinical data from ESCC patients who underwent surgical treatment in the Department of Thoracic Surgery at the First Hospital Affiliated to the University of Science and Technology of China between 2017 and 2019. Based on NPS, CONUT, and PNI scores, optimal cutoff values were determined using X-tile software to divide patients into a high-value group and a low-value group. Differences in clinicopathological characteristics between groups were compared. Survival analysis was performed using Kaplan-Meier method and log-rank test. Multivariate Cox proportional hazards model was used to analyze factors influencing overall survival (OS). The predictive performance of each nutritional index was evaluated by area under receiver operating characteristic curve (AUC). Differences in AUC values among ROC curves were compared using MedCalc software. ResultsA total of 606 ESCC patients were included, comprising 459 males and 147 females, with a mean age of (65.98±7.60) years. Univariate analysis showed that age, squamous cell carcinoma antigen level, NPS, CONUT, PNI, TNM stage, degree of differentiation, and tumor size were all risk factors affecting OS in ESCC patients (P<0.05). Multivariate analysis revealed that age, TNM stage, and NPS were independent risk factors for OS. Among the indices analyzed for prognostic efficacy via AUC values comparison, NPS demonstrated the highest AUC value (0.681) with statistically significant superiority over PNI and CONUT (P<0.05). Conclusion Age, TNM stage, and NPS are independent risk factors affecting the OS of ESCC patients after surgery. Moreover, prognostic evaluation efficacy of NPS surpasses that of PNI and CONUT, indicating its potential as a significant indicator for predicting outcomes in ESCC patients.
ObjectiveTo investigate the effect of different lymph node dissection methods on the prognosis of patients with stage ⅠA spread through air spaces (STAS)-positive lung adenocarcinoma measuring ≤2 cm. MethodsThe clinical data of 3 148 patients with lung adenocarcinoma who underwent surgery at the Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China from 2016 to 2018 were retrospectively analyzed. Patients with stage ⅠA STAS-positive lung adenocarcinoma measuring ≤2 cm were included and divided into two groups based on the extent of lymph node dissection: a systematic lymph node dissection (SLND) group and a limited lymph node dissection (LLND) group. Clinicopathological data between the two groups were compared, and a Cox proportional hazards regression model was used for multivariate survival analysis. ResultsA total of 209 patients (98 males and 111 females) were included. The mean age was (60.42±10.15) years (ranging from 28 to 83 years). All patients successfully completed the surgery. Univariate analysis revealed that the extent of lymph node dissection, past medical history, and micropapillary histological subtype were influencing factors for prognosis. Multivariate analysis indicated that the extent of lymph node dissection, age, and the micropapillary histological subtype were independent influencing factors for prognosis. Furthermore, among STAS-positive patients, those in the SLND group exhibited a better prognosis compared to those in the LLND group. ConclusionThe extent of lymph node dissection is an independent prognostic factor for patients with stage ⅠA STAS-positive lung adenocarcinoma measuring ≤2 cm.Performing SLND may be more beneficial for their long-term prognosis.
