术前转移淋巴结（LN）大小已被报道与食管鳞状细胞癌（ESCC）预后相关。然而，它与术前化疗反应或预后的关系尚未明确。我们调查了转移淋巴结大小与转移性食管癌接受手术患者的术前治疗反应以及预后之间的关系。总共212例临床结节阳性患者接受了食管切除术前化疗。根据术前计算机断层扫描图像中最大LN短轴长度分为三组：＜10 mm（A组），10-19 mm（B组）和≥20 mm（C组）。A组有90例患者（42％），B组有103例患者（49％），C组有19例患者（9％）。与A和B组相比，C组的总转移LN大小的百分比显着降低（22.5％与35.7％，P = 0.037）。C组在组织学检查中的转移LN明显多于A和B组（10.1比2.4，P ＜0.001）。对LN作出反应的C组患者的转移LN比不作出反应的患者少得多（5.1对11.9，P = 0.042）。C组的总体生存率显着低于A组和B组（3年存活率，25.4％对67.3％，P ＜0.001）。然而，LN有反应的C组患者的生存率优于不反应的患者（3年存活率，57.1％对0％，P = 0.008）。有大转移LN的患者反应差且预后差。然而，如果有反应，预计可获得长期生存。©2023 Society of Surgical Oncology.

Pretreatment metastatic lymph node (LN) size has been reported to be associated with prognosis in esophageal squamous cell carcinoma (ESCC). However, its relationship with response to preoperative chemotherapy or prognosis has not been clarified. We investigated the relationship between metastatic LN size and response to preoperative treatment, and prognosis in patients with metastatic esophageal cancer who underwent surgery.A total of 212 clinically node-positive patients who underwent preoperative chemotherapy followed by esophagectomy for ESCC were enrolled. Patients were stratified into three groups on the basis of the length of the short axis of the largest LN in pretreatment computed tomography images: < 10 mm (group A), 10-19 mm (group B), and ≥ 20 mm (group C).Group A had 90 patients (42%), group B had 103 patients (49%), and group C had 19 patients (9%). Group C had significantly lower percent reduction in total metastatic LN size than groups A and B (22.5% versus 35.7%, P = 0.037). Group C had significantly more metastatic LNs based on histological examination than groups A and B (10.1 versus 2.4, P < 0.001). Group C patients whose LNs responded had significantly fewer metastatic LNs than nonresponders (5.1 versus 11.9, P = 0.042). Group C had significantly poorer overall survival than groups A and B (3-year survival, 25.4% versus 67.3%, P < 0.001). However, group C patients whose LNs responded had better survival than nonresponders (3-year survival, 57.1% versus 0%, P = 0.008).Patients with large metastatic LNs have poor response and poor prognosis. However, if a response is obtained, long-term survival can be expected.© 2023. Society of Surgical Oncology.