The analysis of pathological prognostic factors related to lymphovascular invasion (LVI) and perineural invasion (PNI) in esophageal squamous cell carcinoma.

Abstract

e16150 Background: To explore the correlation between lymphovascular invasion(LVI)/perineural invasion(PNI) and other clinical features of esophageal squamous cell carcinoma（ESCC） and its impact on the survival of patients. Methods: 139 patients undergoing esophageal radical surgery were analyzed. Collect clinical data, postoperative pathological results, and postoperative adjuvant treatment information.To analyze the correlation between LVI and PNI status and other pathological factors, and the impact of LVI and PNI status and other pathological factors on the prognosis of ESCC, to evaluate the failure mode of ESCC in different LVI and PNI status, and to explore the role of postoperative adjuvant radiotherapy and chemotherapy. Results: 139 patients were followed up for a median of 61.0 months. The DFS rate in three years was 41.7%, the median DFS was 21 months, the OS rate in three years was 51.0%, and the median OS was 41 months. After propensity score matching analysis, Kaplan-Meier survival analysis showed that the median OS of LVI positive and LVI negative patients was 14.5 months and 49.0 months respectively ( p = 0.012), and 13 patients (65%) in the LVI positive group had distant metastasis.According to Kaplan Meier survival analysis,for LVI-positive patients, adjuvant chemotherapy versus non adjuvant chemotherapy, median DFS was 14 and 6 months ( p = 0.006), and median OS was 25 and 10 months( p = 0.033), respectively. In patients with T3 or N+, the median DFS of adjuvant chemotherapy and non adjuvant chemotherapy were 11 months and 6 months ( p = 0.037) respectively, and the median OS was 25 months and 9 months ( p = 0.0031).Multivariate analysis showed that age ( p = 0.005), LVI ( p < 0.001), T stage ( p = 0.022), and N stage ( p = 0.035) were the prognostic factors for DFS. Multivariate analysis found that age ( p = 0.036), T stage ( p = 0.017), N stage ( p = 0.001), LVI ( p = 0.001) were associated with OS. Pearson chi square test showed that LVI was correlated with T stage ( p < 0.001), N stage ( p = 0.001) and PNI ( p < 0.001). The main failure modes of LVI positive patients were distant metastasis ( p < 0.001) and local progression with distant metastasis ( p = 0.042). LVI status had no significant correlation with local disease progression ( p = 0.303). Conclusions: The lymphovascular invasion (LVI) is one of the poor prognostic factors in patients with esophageal squamous cell carcinoma after radical operation.Failure mode analysis showed that distant metastasis was more common in LVI positive patients.LVI status should be considered in the clinical study of esophageal cancer postoperative adjuvant radiotherapy and postoperative adjuvant chemotherapy.