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Esophageal tumor length predicted long-term survival
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When incorporated into pathological tumor-node-metastasis staging, esophageal tumor length improves the ability to predict long-term survival of patients with esophageal cancer.
Patients with tumors >3 cm with stage I disease had a significantly lower rate of five-year survival compared with patients with tumors ≤3 cm in length.
Using The University of Texas M.D. Anderson Cancer Center database, researchers identified 209 patients with esophageal cancer who underwent surgery between 1995 and 2005 who did not receive preoperative chemotherapy or radiotherapy.
The researchers observed the effects of tumor length on median, three-year and five-year survival and reported a steady decline in all three parameters with increasing tumor length (P<.001). As tumor length crossed the 3 cm mark, they observed a strong decrease in survival.
When separated by histological subgroup in a univariate analysis, tumor length and survival were strongly associated in adenocarcinoma (HR=7.95; 95% CI, 4.9-12.6) compared with squamous cell carcinoma (HR=2.21; 95% CI, 0.96-5.09).
The researchers examined the effect of tumor length on lymph node status and pathologic stage and found that tumor length had a more significant effect on survival in lymph node-negative patients compared with those who were lymph node-positive.
Patients with tumor length ≤3 cm and node-negative patients had superior median survival (median survival not reached) compared with patients with tumor length ≤3 cm and those with node-positive disease (median survival, 36.7 months), those with tumors >3 cm and node-negative patients (median survival, 41.2 months) and patients with a tumor length >3 cm and node-positive disease (median survival, 14.6 months).
Cancer. 2009;115:508-516.