Hollis Alexander C, Quinn Lauren M, Hodson James, Evans Emily, Plowright James, Begum Ruksana, Mitchell Harriet, Hallissey Mike T, Whiting John L, Griffiths Ewen A
College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
J Surg Oncol. 2017 Dec;116(8):1114-1122. doi: 10.1002/jso.24789. Epub 2017 Aug 2.
We investigated the prognostic value of tumor length measurements acquired both from pre-operative imaging and post-operative pathology in esophageal cancer.
Tumor lengths were examined retrospectively for 389 esophagectomy patients with respect to Endoscopy, EUS (Endoscopic Ultrasound), CT and PET-CT, and pathology. Correlations between the measurements on the different approaches were assessed, and associations between tumor length and survival were analyzed.
Only the tumor lengths assessed on pathology were found to be significantly associated with overall (P = 0.001) and recurrence free (P < 0.001) survival on univariable analysis. The median overall survival was 47.1 months in those patients with tumor lengths <3.0 cm, falling to 19.6 and 18.0 months in those with 3.0-4.4 and 4.5+ cm tumors, respectively, demonstrating a reduction in patient survival at a tumor length of around 3 cm. Tumor length on pathology was significantly correlated with tumor differentiation and both T- and N-categories. After accounting for these factors, tumor length on pathology was a significant independent predictor of recurrence-free (P = 0.016), but not overall (P = 0.128) survival.
Tumor lengths on pathology were found to be the most predictive of patient outcome. However, after accounting for other tumor-related factors, tumor length only resulted in a marginal improvement in predictive accuracy.
我们研究了食管癌术前影像学检查和术后病理检查所获得的肿瘤长度测量值的预后价值。
回顾性分析389例接受食管切除术患者的肿瘤长度，涉及内镜检查、超声内镜（EUS）、CT和PET-CT以及病理检查。评估不同方法测量值之间的相关性，并分析肿瘤长度与生存率之间的关联。
单因素分析发现，仅病理评估的肿瘤长度与总生存期（P = 0.001）和无复发生存期（P < 0.（此处原文有误，应为P < 0.001））显著相关。肿瘤长度<3.0 cm的患者中位总生存期为47.1个月，肿瘤长度为3.0 - 4.4 cm和4.5 + cm的患者分别降至19.6个月和18.0个月，表明肿瘤长度约为3 cm时患者生存率降低。病理上的肿瘤长度与肿瘤分化以及T和N分期显著相关。在考虑这些因素后，病理上的肿瘤长度是无复发生存期（P = 0.016）的显著独立预测因素，但不是总生存期（P = 0.128）的独立预测因素。
发现病理上的肿瘤长度对患者预后最具预测性。然而，在考虑其他肿瘤相关因素后，肿瘤长度仅在预测准确性上有轻微改善。
