Factors on prognosis in patients of stage pT3N0M0 thoracic esophageal squamous cell carcinoma after two-field esophagectomy.

AIMS

To evaluate prognosis and its related factors in patients of pT3N0M0 thoracic esophageal squamous cell carcinoma (ESCC).

SUBJECTS AND METHODS

From January 2008 to December 2009, 249 patients of stage T3N0M0 thoracic ESCC were treated with two-field esophagectomy. Among them, 171 males and 78 females; the median age was 60 years old (range 33-78 years). Site of lesion: 39 in upper-, 166 in middle-, and 44 patients in lower-thoracic esophagus; the median length of lesion was 5 cm (range 2-12 cm); the degree of adhesion during surgery: No adhesions in 35, mild adhesions in 90, and severe adhesions in 124 patients; the median number of dissected lymph node (LN) was 9 (range 1-27). Ninety-eight patients are treated with surgery alone, 151 patients with postoperative adjuvant treatment (20 with radiotherapy, 110 with chemotherapy, and 21 patients with radiotherapy and chemotherapy). Statistical analysis was performed using SPSS 13.0 statistical software.

RESULTS

Follow-up deadline was July 2013. The 1-, 3-, 5-year overall survival (OS) were 90.0%, 68.7% and 55.2%; Univariate analysis identified gender, location of lesion, differentiation of pathology and hemoglobin (Hb) levels were prognostic factors for OS (P < 0.05); multivariate analysis showed, location of lesion, Hb levels, mediastinal small LN (<1 cm in diameter) in computed tomography (CT) image before surgery, and number of removed LN were independent prognostic factors for OS. The 1-, 3-, 5-year progress-free survival (PFS) were 82.1%, 61.7%, and 53.9%; univariate analysis identified, age, site of lesion and degree of adhesion during surgery were associated with PFS (P < 0.05); multivariate analysis showed, site of lesion was the only independent prognostic factor. Postoperative adjuvant therapy did not effect on OS and PFS.

CONCLUSION

For patients of pT3N0M0 thoracic ESCC, the independent factors were the site of a lesion for OS and PFS, Hb levels, small LN in CT, and number of removed LN for OS. The value of postoperative adjuvant therapy need be further proved.