Jeon J H, Lee J M, Moon D H, Yang H C, Kim M S, Lee G-K, Zo J I
Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
Eur J Surg Oncol. 2017 Feb;43(2):471-477. doi: 10.1016/j.ejso.2016.11.002. Epub 2016 Nov 22.
The purpose of this study was to analyze the risk factors of recurrence in patients with early stage esophageal squamous cell carcinoma (ESCC).
We retrospectively analyzed the medical records of 190 patients with confirmed T1N0M0 ESCC after curative esophagectomy. The following potential prognostic factors for recurrence were investigated: age, sex, pathologic T category, tumor location, differentiation grade, tumor size, venous invasion, angiolymphatic invasion, perineural invasion and the maximum standardized uptake value (SUVmax) of the primary tumor.
There were 174 male and 16 female patients with a median age of 66.0 years (range, 42.0-79.0 years). The pathologic status of the surgically resected ESCCs was T1a in 93 patients (48.9%) and T1b in 97 patients (51.1%). The median number of dissected lymph nodes was 35 (range, 10 to 86), and all lymph nodes were negative for tumors. The multivariate analysis showed presence of venous invasion [HR (hazard ratio), 11.433; P < 0.001) and SUVmax ≥ 3.2 (HR, 2.830; P = 0.011) as independent risk factors for recurrence. The 5-year recurrence-free survival (RFS) was 25.0% for patients with venous invasion and 78.9% for those without (P < 0.001). The 5-year RFS was 67.1% for patients with an SUVmax ≥3.2 and 81.5% for those with an SUVmax <3.2 (P = 0.003).
Venous invasion and high SUVmax could be important prognostic factors coupled with the TNM staging system, in patients with early stage ESCC.
本研究旨在分析早期食管鳞状细胞癌（ESCC）患者复发的危险因素。
我们回顾性分析了190例经根治性食管切除术后确诊为T1N0M0期ESCC患者的病历。研究了以下复发的潜在预后因素：年龄、性别、病理T分期、肿瘤位置、分化程度、肿瘤大小、静脉侵犯、血管淋巴管侵犯、神经周围侵犯以及原发肿瘤的最大标准化摄取值（SUVmax）。
共有174例男性和16例女性患者，中位年龄为66.0岁（范围42.0 - 79.0岁）。手术切除的ESCC病理状态为T1a期93例（48.9%），T1b期97例（51.1%）。清扫淋巴结的中位数为35个（范围10 - 86个），所有淋巴结均无肿瘤转移。多因素分析显示静脉侵犯[风险比（HR），11.433；P < 0.001]和SUVmax≥3.2（HR，2.830；P = 0.011）是复发的独立危险因素。有静脉侵犯患者的5年无复发生存率（RFS）为25.0%，无静脉侵犯患者为78.9%（P < 0.001）。SUVmax≥3.2患者的5年RFS为67.1%，SUVmax < 3.2患者为81.5%（P = 0.003）。
对于早期ESCC患者，静脉侵犯和高SUVmax可能是与TNM分期系统相结合的重要预后因素。
