INTRODUCTION: The impact of esophageal tumor length on pT1 esophageal adenocarcinoma has not been well evaluated. METHODS: Case histories of all patients (n = 133) undergoing esophageal resection from 1979 to 2007 with pT1 adenocarcinoma of the esophagus were reviewed. Univariate and multivariate analyses of esophageal tumor length and other standard prognostic factors were performed. RESULTS: Patients with early-stage pT1 esophageal adenocarcinoma with tumors less than 3 cm demonstrate decreased long-term survival (3 years: >3 cm = 46% vs 93%; P < .001) and higher risk of lymph node involvement (lymph node positive: >3 cm = 47% vs 10%; P < .001). Multivariable analysis shows that esophageal tumor length (>3 cm) is an independent risk factor for survival in patients with pT1 early-stage esophageal cancer (hazard ratio: 4.8, 95% confidence intervals: 1.4-16.5; P < .001) even when controlled for submucosal involvement, lymph node involvement, and lymphatic/vascular invasion status. In combination with submucosal involvement, esophageal tumor length (>3 cm) identifies a high-risk population of pT1 esophageal adenocarcinoma (3 years: group 1 [0 risk factors] = 100%, group 2 [1 risk factor] = 87%, and group 3 [2 risk factors] = 33%; P < .001). CONCLUSIONS: This study demonstrates that esophageal tumor length (>3 cm) is a risk factor for long-term survival and lymph node involvement in early-stage pT1 esophageal adenocarcinoma. Esophageal tumor length (>3 cm) in combination with submucosal involvement may help to identify a high-risk group of patients with pT1 esophageal adenocarcinoma.
INTRODUCTION: The impact of esophageal tumor length on pT1esophageal adenocarcinoma has not been well evaluated. METHODS: Case histories of all patients (n = 133) undergoing esophageal resection from 1979 to 2007 with pT1adenocarcinoma of the esophagus were reviewed. Univariate and multivariate analyses of esophageal tumor length and other standard prognostic factors were performed. RESULTS:Patients with early-stage pT1esophageal adenocarcinoma with tumors less than 3 cm demonstrate decreased long-term survival (3 years: >3 cm = 46% vs 93%; P < .001) and higher risk of lymph node involvement (lymph node positive: >3 cm = 47% vs 10%; P < .001). Multivariable analysis shows that esophageal tumor length (>3 cm) is an independent risk factor for survival in patients with pT1 early-stage esophageal cancer (hazard ratio: 4.8, 95% confidence intervals: 1.4-16.5; P < .001) even when controlled for submucosal involvement, lymph node involvement, and lymphatic/vascular invasion status. In combination with submucosal involvement, esophageal tumor length (>3 cm) identifies a high-risk population of pT1esophageal adenocarcinoma (3 years: group 1 [0 risk factors] = 100%, group 2 [1 risk factor] = 87%, and group 3 [2 risk factors] = 33%; P < .001). CONCLUSIONS: This study demonstrates that esophageal tumor length (>3 cm) is a risk factor for long-term survival and lymph node involvement in early-stage pT1esophageal adenocarcinoma. Esophageal tumor length (>3 cm) in combination with submucosal involvement may help to identify a high-risk group of patients with pT1esophageal adenocarcinoma.
Authors: James Welsh; Arya Amini; Anna Likhacheva; Jeremy Erasmus J; Daniel Gomez; Marta Davila; Reza J Mehran; Ritsuko Komaki; Zhongxing Liao; Wayne L Hofstetter; Jeffrey Lee H; Manoop S Bhutani; Jaffer A Ajani Journal: Curr Oncol Rep Date: 2011-06 Impact factor: 5.075
Authors: Michael F Nentwich; Katharina von Loga; Matthias Reeh; Faik G Uzunoglu; Andreas Marx; Jakob R Izbicki; Dean Bogoevski Journal: J Gastrointest Surg Date: 2013-10-04 Impact factor: 3.452
Authors: J A Ajani; A M Correa; W L Hofstetter; D C Rice; M A Blum; A Suzuki; T Taketa; J Welsh; S H Lin; J H Lee; M S Bhutani; W A Ross; D M Maru; H A Macapinlac; J Erasmus; R Komaki; R J Mehran; A A Vaporciyan; S G Swisher Journal: Ann Oncol Date: 2012-07-24 Impact factor: 32.976