The online version of this article (doi:10.1186/1477-7819-10-273) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
YZ and ZS cooperated in the conception and design of the study, and in the collection of the data;JW and BL validated all pathology reports, and assisted in data analysis and interpretation of data; andZS drafted the manuscript. All authors approved the final manuscript.
Tumor length is an important prognostic factor for many carcinomas, but its role in esophageal cancer remained undetermined. The aim of this study was to investigate the effect of tumor length on survival for patients with confined tumors (grade pT1-2) without lymph-node metastases in esophageal squamous cell carcinoma.
We enrolled 201 patients with esophageal squamous cell carcinoma (SCC) who had undergone surgical resection and been confirmed as pT1-2N0M0. The relationship of tumor length with overall survival was assessed and compared with other factors detailed in the American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging system published in 2009.
The overall survival (OS) rates at 1, 3, and 5 years were 93.0%, 83.7%, and 69.2%, respectively. The tumor length adversely affected OS, with the 5-year rate being 93.5%, 82.0%, 68.6%, 67.9%, 55.3% and 41.1%, respectively for tumor lengths of less than 10 mm, 10 to 20 mm, 20 to 30 mm, 30 to 40 mm, 40 to 50 mm, and greater than 50 mm (P< 0.001). Multivariate analyses showed that the pathologic T classification and grade of tumor was significantly associated with OS. Tumor length of 30 mm or more remained an independent prognostic factor (P = 0.04), as did the other current TNM factors.
Tumor length appears to affect the OS of patients with early-stage esophageal squamous cell carcinoma. It may provide additional prognostic information for the current TNM staging system.
American Joint Committee on Cancer: Manual for Staging of Cancer. Edited by: Beahrs OH, Myers MH. 1983, Philadelphia, PA: JB Lippincott, 2
Edge SB, Byrd DR, Compton CC: American Joint Committee on Cancer (AJCC) Cancer Staging Manual. 2010, Chicago: Springer, Inc
Griffiths EA, Brummell Z, Gorthi G, Pritchard SA, Welch IM: Tumor length as a prognostic factor in esophageal malignancy: univariate and multivariate survival analyses. J SurgOncol. 2006, 93: 258-267.
Bolton WD, Hofstetter WL, Francis AM, Correa AM, Ajani JA, Bhutani MS, Erasmus J, Komaki R, Maru DM, Mehran RJ, Rice DC, Roth JA, Vaporciyan AA, Walsh GL, Swisher SG: Impact of tumor length on long-term survival of pT1 esophageal adenocarcinoma. J ThoracCardiovascSurg. 2009, 138: 831-836.
Rice TW, Rusch VW, Blackstone EH: AJCC/UICC staging of esophageal cancer. General Thoracic Surgery. 7th edition,Vol 2. Edited by: Shields TW, Locicero J, Reed CE, Feins RH. 2009, Amsterdam, Netherlands: Wolters, Kluwer, 2013-2015.
Bollschweiler E, Baldus SE, Schröder W, Schneider PM, Hölscher H: Staging of esophageal carcinoma: length of tumor and number of involved regional lymph nodes. Are these independent prognostic factors?. J SurgOncol. 2006, 94: 355-363.
Wang BY, Goan YG, Hsu PK, Hsu WH, Wu YC: Tumor Length as a prognostic factor in esophageal squamous cell carcinoma. Ann ThoracSurg. 2011, 91: 887-893. 10.1016/j.athoracsur.2010.11.011. CrossRef
Mariette C, Piessen G, Briez N, Triboulet JP: The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvantchemoradiation or lymphadenectomy extent. Ann Surg. 2008, 247: 365-371. 10.1097/SLA.0b013e31815aaadf. CrossRefPubMed
Yang HX, Xu Y, Fu JH, Wang JY, Lin P, Rong TH: An evaluation of the number of lymph nodes examined and survival for node-negative esophageal carcinoma:data from China. Ann SurgOncol. 2010, 17: 1901-1911.
Peyre CG, Hagen JA, DeMeester SR, Altorki NK, Ancona E, Griffin SM, Hölscher A, Lerut T, Law S, Rice TW, Ruol A, van Lanschot JJ, Wong J, DeMeester TR: The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg. 2008, 248: 549-556. CrossRefPubMed
Schwarz RE, Smith DD: Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J GastrointestSurg. 2007, 11: 1384-10.1007/s11605-007-0264-2. CrossRef
- Analysis of the tumor length and other prognosis factors in pT1-2 node-negative esophageal squamous cell carcinoma in a Chinese population
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II