The total number of resected lymph node is not a prognostic factor for recurrence in esophageal squamous cell carcinoma patients undergone transthoracic esophagectomy

Background: The total number of resected lymph nodes (TLN) has been shown to predict survival in esophageal cancer, but its relationship with recurrence has been rarely reported. We aim to study the prognostic factors in esophageal squamous cell carcinoma (ESCC) patients, with a particular focus on the role of TLN. Methods: Two hundred sixty-eight ESCC patients who underwent transthoracic esophagectomy were selected for the study. A Cox regression model was used to identify prognostic factors. Results: Recurrence occurred in 115 of 268 patients. The median time to recurrence was 10 months (range, 1-58). The recurrence-free survival at 1, 3, and 5 years was 62.3%, 32.1%, and 28.5%, respectively. Multivariate analysis identified age (P = 0.001), N stage (N1-3 vs. N0, P = 0.001), tumor length (P = 0.019), and development of recurrence (P < 0.001) as independent prognostic factors for overall survival, whereas T (T3/4 vs. T1/2, P = 0.029) and N stage (N1-3 vs. N0, P = 0.017) were independent prognostic factors for recurrence. TLN was a significant factor only when predicting overall survival in N0 patients (HR, 0.976; 95% CI, 0.953-0.999; P = 0.042). Conclusion: The TLN is not a prognostic factor for recurrence in ESCC patients undergone transthoracic esophagectomy.