Haisley Kelly R, Hart Kyle D, Fischer Laura E, Kunio Nicholas R, Bakis Gene, Tieu Brandon H, Schipper Paul H, Sheppard Brett C, Hunter John G, Dolan James P
Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Pk Rd, L223A Portland, OR 27239, USA.
Advocate Medical Group, Division of General and Vascular Surgery, Department of Surgery, Elgin, IL, USA.
Am J Surg. 2016 May;211(5):860-6. doi: 10.1016/j.amjsurg.2016.01.007. Epub 2016 Feb 23.
Although tumor length has received little attention for staging of esophageal cancer, it may be a valid prognostic feature for node positivity and survival.
Through retrospective review of a prospective institutional database, esophageal cancer patients who completed esophagectomy without neoadjuvant chemoradiation were analyzed. Pathologic tumor lengths were compared with node positivity and survival through a zero-inflated negative binomial regression model and multivariable Cox proportional hazards model, respectively.
Between January 2000 and July 2015, 98 patients met inclusion, criteria (84% male, median age of 65, 90% adenocarcinoma). Median tumor length was 2.5 cm with each 1-cm increase in length increasing the odds of node positivity (odds ratio 3.55, 95% confidence interval 1.50 to 8.40, P = .004) and decreasing overall survival (hazards ratio 1.18, 95% confidence interval 1.06 to 1.32, P < .003).
This study suggests an association among tumor length, lymph node metastasis, as well as overall survival in esophageal cancer patients who have not received neoadjuvant chemoradiotherapy.
