BackgroundTo compare the right and left transthoracic approach on the post-operative survival of patients with lymph node-negative esophageal squamous cell carcinoma.MethodsSix hundred and ninety-five ESCC patients who underwent esophagectomy between 1990 and 2005 were retrospectively enrolled in the present study and were confirmed by histology to be of no lymph node metastasis. Those who had received neoadjuvant chemotherapy or radiotherapy were excluded from the study. Patients were divided into two groups, the left (n = 545) and right (n = 150) transthoracic groups. The follow-up duration ranged from 1 to 20 years with a mean of 7 years. Kaplan–Meier and univariate and multivariate Cox proportional hazards were used for analysis.Results3- and 5-year CSS rates were 62.0 % and 44.0 % in the left group, while the corresponding figures in the right group were 56.0 % and 40.0 %(P < 0.05). The overall survival for the two groups was significantly different (P = 0.045). Survival analyses were stratified by stages, which found that the favorable survival advantage was not present. When the survival curves were stratified by tumor locations, a significant difference was not revealed. Surgical approaches were regarded as one of the prognostic factors in the univariate analysis (P = 0.019). However, this significance could not be confirmed in multivariate Cox regression analysis (P = 0.193).ConclusionsThe left transthoracic approach is superior in some aspects to the right transthoracic approach regarding surgical and oncological outcomes in the treatment of lymph node negative ESCC.

BackgroundThe association between esophageal cancer and prediagnosis alcohol consumption is well established. However, evidence that prediagnosis alcohol consumption affects postoperative survival in patients with lymph node-negative esophageal squamous cell carcinoma (ESCC) is lacking. We conducted a retrospective study on the effect of prediagnosis alcohol consumption on the postoperative survival of patients with lymph node-negative ESCC in China.MethodsWe enrolled 643 ESCC patients with negative lymphatic metastasis who had undergone esophagectomy between 1990 and 2005 at the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China, and reviewed their demographic, pathologic, preoperative, and cancer outcome data obtained from medical records. These data were analyzed using life table and Kaplan–Meier analyses and multivariate Cox regression.ResultsThere was a significant reduction in 3- and 5-year survival in drinkers with lymph node-negative ESCC. For drinkers, 3- and 5-year survival rates were 43% and 36% respectively, whereas, for nondrinkers, the corresponding values were 63% and 58%, respectively (p < 0.05). Multivariate Cox regression showed that drinking (p = 0.001, relative risk =1.583) was an independent factor for survival in patients with lymph node-negative ESCC. Striated analysis revealed that drinking was an independent factor for survival in patients with stage II A (p = 0.008, relative risk =1.679), stage IB (p = 0.044, relative risk=1.517), and well (p=0.011, relative risk =1.783) and moderately (p = 0.002, relative risk = 1.915) differentiated ESCC.ConclusionsPrediagnosis alcohol consumption is an independent prognostic factor for postoperative survival in patients with lymph node-negative ESCC.

BackgroundThe Glasgow Prognostic Score (GPS) is an established inflammation-based system that is used to predict the prognosis for several types of malignancies. In this retrospective study, we assessed the postoperative survival of 725 patients with non-metastatic esophageal squamous cell carcinoma who had normal preoperative serum tumor marker levels according to the GPS.MethodsAmong 1394 patients who underwent esophagectomy between August 2006 and December 2010, 725 with normal preoperative serum levels of carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) were enrolled. All demographic, pathologic, and survival data were analyzed retrospectively. Uni- and multivariate analyses were performed to evaluate the relationship with overall survival. The Kaplan–Meier analysis and log-rank tests were used to compare the survival curves between patients with GPS 0 (group A) and 1 or 2 (group B).ResultsPatients in group A exhibited significantly better 3- and 5-year cancer-specific survival (CSS) rates (0.780 and 0.759, respectively) than those in group B (0.624 and 0.605, respectively). Multivariate Cox regression analysis revealed that age, tumor length, pathological tumor-node-metastasis (pTNM) stage, venous invasion, lymph node metastasis, serum albumin and C-reactive protein levels, and GPS were associated with postoperative survival of these patients. Further multivariate analysis confirmed that GPS was an independent prognostic factor. The Kaplan–Meier analysis and log-rank tests demonstrated a significant difference in CSS between groups A and B (P = 0.001).ConclusionsGPS may be a valuable prognostic indicator for esophageal cancer patients with normal preoperative CEA and SCC-Ag serum levels.

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