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Spatial nodal pattern refines disease-free survival stratification beyond pathological N stage in resected esophageal squamous cell carcinoma - PubMed

3 hours ago
  • #Prognostic Stratification
  • #Esophageal Cancer
  • #Spatial Nodal Pattern
  • Spatial-N pattern classification was developed to improve disease-free survival stratification beyond conventional pathological N staging in resected esophageal squamous cell carcinoma (ESCC).
  • The classification is hierarchical and based on station-level nodal mapping: Pattern 0 (N0), Pattern 1 (single-region metastasis), Pattern 2 (RLN-chain high-risk station involvement), and Pattern 3 (cross-region metastasis).
  • In a retrospective analysis of 1,276 patients, Spatial-N pattern significantly stratified 3-year DFS, with distinct outcomes across patterns (adjusted hazard ratios from 3.14 to 10.25 vs. Pattern 0).
  • The Spatial-N model outperformed the 8th AJCC pathological N staging in discrimination (C-index: 0.731 vs. 0.699; 3-year AUC: 0.775 vs. 0.742).
  • An integrated model combining Spatial-N pattern with other clinical factors achieved the highest predictive performance (C-index: 0.747; 3-year AUC: 0.794).