Endoscopic Tumor Length Is an Independent Prognostic Factor in Esophageal Squamous Cell Carcinoma |
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Authors: | Bing-Yen Wang MD Chao-Yu Liu MD Ching-Hsiung Lin MD PhD Po-Kuei Hsu MD Wen-Hu Hsu MD Yu-Chung Wu MD Ching-Yuan Cheng MD |
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Institution: | Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, and Chung Shan Medical University, Taichung, Taiwan. bywang1@gmail.com |
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Abstract: | Purpose To investigate the impact of endoscopic esophageal tumor length on survival for patients with resected esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed the clinicopathologic characteristics of 244 ESCC patients who underwent curative resection as the primary treatment at Taipei Veterans General Hospital between January 2000 and November 2010. The endoscopic tumor length was defined as a uniform measurement before completion of the esophagectomy. The impact of endoscopic tumor length on a patient??s overall survival (OS) and disease-free survival (DFS) were assessed. A Cox regression model was used to identify prognostic factors. Results The 1-, 3-, and 5-year OS rates were 81.2, 48.2, and 39.6%, respectively, with a median survival time of 18.0?months. The 1-, 3-, and 5-year DFS rates were 66.2, 34.7, and 32.4%, respectively, with a median DFS of 15.0?months. Endoscopic tumor length correlated with pathologic tumor length Pearson correction (r)?=?0.621; P?0.001] Regression trees analyses suggested an optimum cutoff point of >4?cm to identify patients with decreased long-term survival. In multivariate survival analysis, endoscopic tumor length (more or less than 4?cm) remained an independent prognostic factor for both OS (P?=?0.006) and DFS (P?=?0.002). Conclusions Endoscopic tumor length could have a significant impact on both the OS and DFS of patients with resected ESCC and may provide additional prognostic value to the current tumor, node, and metastasis staging system before patients receive any cancer-specific treatment. |
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