Yang Yu-Shang, Hu Wei-Peng, Ni Peng-Zhi, Wang Wen-Ping, Yuan Yong, Chen Long-Qi
Department of Thoracic Surgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, China.
Oncotarget. 2017 Jun 27;8(26):43397-43405. doi: 10.18632/oncotarget.14762.
Predictive value of preoperative endoscopic characteristic of esophageal tumor has not been fully evaluated. The aim of this study is to investigate the impact of esophageal luminal stenosis on survival for patients with resectable esophageal squamous cell carcinoma (ESCC).
The clinicopathologic characteristics of 623 ESCC patients who underwent curative resection as the primary treatment between January 2005 and April 2009 were retrospectively reviewed. The esophageal luminal stenosis measured by endoscopy was defined as a uniform measurement preoperatively. The impact of esophageal luminal stenosis on patients' overall survival (OS) and relation with other clinicopathological features were assessed. A Cox regression model was used to identify prognostic factors.
The results showed that OS significantly decreased in patients with manifest stenotic tumor compared with patients without luminal obstruction (P<0.05). Considerable esophageal luminal stenosis was associated with a higher T stage, longer tumor length, and poorer differentiation (all P<0.05). In multivariate survival analysis, esophageal luminal stenosis remained as an independent prognostic factor for OS (P= 0.036).
Esophageal luminal stenosis could have a significant impact on the OS in patients with resected ESCC and may provide additional prognostic value to the current staging system before any cancer-specific treatment.
食管肿瘤术前内镜特征的预测价值尚未得到充分评估。本研究旨在探讨食管腔狭窄对可切除食管鳞状细胞癌（ESCC）患者生存的影响。
回顾性分析2005年1月至2009年4月间623例行根治性切除作为主要治疗的ESCC患者的临床病理特征。术前通过内镜测量的食管腔狭窄定义为术前的统一测量值。评估食管腔狭窄对患者总生存（OS）的影响及其与其他临床病理特征的关系。采用Cox回归模型确定预后因素。
结果显示，与无管腔阻塞的患者相比，有明显狭窄肿瘤的患者OS显著降低（P<0.05）。明显的食管腔狭窄与更高的T分期、更长的肿瘤长度和更差的分化相关（均P<0.05）。在多因素生存分析中，食管腔狭窄仍然是OS的独立预后因素（P = 0.036）。
食管腔狭窄可能对切除的ESCC患者的OS有显著影响，并且在任何癌症特异性治疗之前可能为当前分期系统提供额外的预后价值。
