Effect of postoperative adjuvant chemotherapy on esophageal squamous cell carcinoma patients with lymphovascular invasion and without lymph node metastasis

Abstract Objectives To explore the significance of postoperative adjuvant chemotherapy for esophageal squamous cell carcinoma patients with lymphovascular invasion (LVI) and without lymph node metastasis and analyze the recurrence pattern of these patients. Methods Data of patients who underwent radical resection of esophageal cancer at Henan Cancer Hospital between January 2015 and December 2016 were collected. Patients with LVI and without lymph node metastasis were retrieved based on the pathological results. Patients were divided into the adjuvant chemotherapy (AC) group and none chemotherapy (NC) group according to the postoperative treatment strategy. The follow-up information of the two groups was compared. Results A total of 46 patients were enrolled. Twenty-two patients received postoperative adjuvant therapy, 24 patients did not receive postoperative treatment. By December 2021, 27 patients had died. The 5-year overall survival (OS) rate was 41.3%, and the median follow-up time was 34.5 months. The 5-year OS rate was 40.9% in the AC group and 41.7% in the NC group. No significant difference in the OS was found between the two groups. Subgroup analysis showed that the 5-year OS rate of stage IB patients was better in the AC group than in the NC group (83.3% vs 40.0%), but with no statistical significance. No significant difference in the 5-year OS rate was found between the AC group and the NC group for stage IIA (33.3%% vs. 66.7%) and IIB (20.0% vs. 20.0%) patients. Univariate and multivariate analyses showed that the T stage (P = 0.034, OR = 4.497) and the S stage (P = 0.025, OR = 5.033) were independent risk factors affecting the OS. The postoperative treatment strategy was not related to the OS. Local lymph node recurrence and distant metastasis were the main recurrence patterns in these patients. Conclusions Esophageal squamous cell carcinoma patients with LVI and negative lymph nodes did not benefit from postoperative chemotherapy. T stage and S stage were independent risk factors for the OS. Patients with LVI are more likely to develop distant metastases and local lymph node recurrence post-surgery.