Lymphovascular Invasion as a Prognostic Factor in Non-Metastatic Adenocarcinoma of Esophagogastric Junction After Radical Surgery

Abstract

Chengbin Zheng,1,* Xingyu Feng,2,* Jiabin Zheng,2 Qian Yan,2 Xu Hu,2 Huolun Feng,2 Zhenru Deng,2 Qianchao Liao,2 Junjiang Wang,2 Yong Li1,2 1Department of General Surgery, Guangdong Provincial People’s Hospital; Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510080, People’s Republic of China; 2Department of General Surgery, Guangdong Provincial People’s Hospital; Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yong LiDepartment of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, 106 Zhongshan Road 2, Guangzhou, Guangzhou 510080, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: Tumors with lymphovascular invasion (LVI) are thought to be associated with lymph node metastasis and to lead to a worse prognosis. However, the effect of LVI on the prognosis of adenocarcinoma of esophagogastric junction (AEG) is still unclear.Patients and Methods: We retrospectively analyzed 224 consecutive patients with non-metastatic AEG who underwent radical surgery in our hospital from 2004 to 2018. Inverse probability weighting (IPW) analysis was used to eliminate the selection bias. IPW-adjusted Kaplan–Meier curves and Cox proportional hazards models were used to compare disease-specific survival (DSS) and overall survival (OS) between patients with and without LVI.Results: A total of 224 patients with non-metastatic AEG who underwent radical resection were included in the study and 96 (42.9%) patients developed LVI. Survival analysis showed that LVI were associated with worse DSS (hazard ratio (HR) = 3.12; 95% CI: 1.93– 5.03) and worse OS (HR = 2.33; 95% CI: 1.61– 3.38). The results were consistent across subgroups stratified by pathologic N stage. Subgroup analysis demonstrated that Siewert type III (HR= 3.20, 95% CI: 1.45– 7.06) was associated with worse DSS, but not Siewert type I/II (HR= 1.46, 95% CI: 0.94– 2.31, P-interaction=0.047).Conclusion: LVI are associated with worse prognosis in AEG. LVI had a worse effect on DSS in Siewert type III AEG than Siewert type I/II AEG.Keywords: lymphovascular invasion, adenocarcinoma of esophagogastric junction, risk factor, overall survival, disease-specific survival

Keywords

• lymphovascular invasion
• adenocarcinoma of esophagogastric junction
• risk factor
• overall survival；disease-specific survival