Evidence map›Paper›PMID 39918200›Full record

SynthesisCancer medicine2025

Nodal Downstaging of Esophageal Cancer After Neoadjuvant Therapy: A Cohort Study and Meta-Analysis.

Feng Su, Xu Huang, Jun Yin, Hang Tang, Lijie Tan, Yaxing Shen

Abstract readMeta-Analysis
In one paragraph

Synthesis in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Feng SuDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0001-7469-5499
Xu HuangDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0003-1017-4197
Jun YinDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Hang TangDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Lijie TanDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Yaxing ShenDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Funding

China Postdoctoral Science Foundation 2018M631394National Natural Science Foundation of China 81400681Science and Technology Innovation Plan Of Shanghai Science and Technology Commission 22Y11907200
6 · The paper itself

Abstract

backgroundIn esophageal cancer, the ypN0 status after induction therapy could be categorized into two primary groups: "natural N0" (cN0/ypN0) and "down-staged N0" (cN+/ypN0). The assessment of cN status is typically based on clinical imagination or pathological regression. However, there is no standardized method for evaluating cN/ypN status. This study aims to investigate the prognosis of patients with cN+/ypN0 using both assessment methods through a cohort study and meta-analysis.

methodsA prospectively maintained database encompassing esophageal cancer patients undergoing induction therapy followed by radical esophagectomy was comprehensively reviewed. The prognostic significance of cN+/ypN0 across two evaluation methods was quantified. Additionally, a meta-analysis using data from previous studies was conducted.

results578 patients were identified from the cohort analysis, with 342 classified as ypN0 and 236 as ypN+. When evaluated with clinical imagination, patients with cN+/ypN0 had survival outcomes comparable to those with natural N0 but significantly better than those with ypN+ (p < 0.001). Using pathological nodal regression, cN+/ypN0 patients showed superior overall survival compared to ypN+ patients (p = 0.0043), although their disease-free survival was notably inferior to that of natural N0 patients (p = 0.0088). A meta-analysis of 20 previous studies confirmed the prognostic value of cN+/ypN0 status in both clinical imagination and pathological regression.

conclusionsFor esophageal cancer patients receiving neoadjuvant, cN+/ypN0 status, assessed through both clinical imagination and pathological regression, serves as a significant prognostic factor. It holds precedence over ypN+ yet falls short of the natural N0. The pre-treatment categorizations warrant recognition as a novel and pertinent staging metric.

Indexed as

Esophageal NeoplasmsLymph NodesNeoadjuvant TherapyAgedCohort StudiesEsophagectomyFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm StagingPrognosisesophageal cancerneoadjuvant therapynodal downstagingsurvival

Identifiers

PMID39918200
PMCPMC11803740

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.