Guo Wei, Xiao Hua-Liang, Ma Zheng, Liu Hui-Jun, Wang Ying-Jian, Mei Long-Yong, Liu Xue-Hai, Jiang Yao-Guang, Wang Ru-Wen
Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China,
Ann Surg Oncol. 2014 Aug;21(8):2540-5. doi: 10.1245/s10434-014-3636-3. Epub 2014 Mar 17.
In patients with esophageal squamous cell carcinoma (ESCC), pathologic examination allows T2 tumors to be further subclassified according to whether the circular or longitudinal muscle layers are invaded. Therefore, we aimed to investigate whether subclassifying the T2 stages can aid in determining the prognosis for patients with ESCC.
The clinical and pathologic characteristics of 85 ESCC patients with T2 tumors who underwent thoracoscopic esophagectomy between 2008 and 2013 were retrospectively analyzed. Univariate and multivariate analyses were performed to identify prognostic factors. The Kaplan-Meier method was used to compare survival differences with respect to each prognostic factor.
Thirty-nine patients had tumors invading the circular muscle layer and were designated as having T2a disease. The remaining 46 patients had T2b disease, with tumors invading the longitudinal muscle layer. The overall 1-, 3-, and 5-year survival rates were 96.1, 53.8, and 36.4 %, respectively, with a median survival of 39.0 months. Univariate analysis indicated that sex, smoking history, grade, location, and tumor length did not significantly influence on survival. Only T stage (P = 0.017) and N stage (P = 0.003) were associated with survival. The results of multivariate Cox proportional hazard regression analysis showed that T stage (P = 0.045) and N stage (P = 0.003) were independent prognostic factors.
N stage and subclassified T stage are independent prognostic factors in patients with T2 tumors. Therefore, we concluded that T2 tumors can be subclassified further into T2a and T2b stages, and patients with different T2 stages may have different prognoses.
在食管鳞状细胞癌（ESCC）患者中，病理检查可根据环形肌层或纵行肌层是否受侵对T2期肿瘤进行进一步亚分类。因此，我们旨在研究T2期亚分类是否有助于确定ESCC患者的预后。
回顾性分析2008年至2013年间85例接受胸腔镜食管切除术的T2期ESCC患者的临床和病理特征。进行单因素和多因素分析以确定预后因素。采用Kaplan-Meier法比较各预后因素的生存差异。
39例患者肿瘤侵犯环形肌层，被指定为T2a期疾病。其余46例患者为T2b期疾病，肿瘤侵犯纵行肌层。总体1年、3年和5年生存率分别为96.1%、53.8%和36.4%，中位生存期为39.0个月。单因素分析表明，性别、吸烟史、分级、位置和肿瘤长度对生存无显著影响。仅T分期（P = 0.017）和N分期（P = 0.003）与生存相关。多因素Cox比例风险回归分析结果显示，T分期（P = 0.045）和N分期（P = 0.003）是独立的预后因素。
N分期和亚分类的T分期是T2期肿瘤患者的独立预后因素。因此，我们得出结论，T2期肿瘤可进一步亚分为T2a和T2b期，不同T2期的患者可能有不同的预后。
