Tumour length as an independent prognostic factor in resectable oesophageal carcinoma

Abstract

Introduction Oesophageal longitudinal tumour length has been investigated as a prognostic indicator for disease recurrence and overall survival in resectable oesophageal carcinoma. However, there is conflicting evidence regarding its use in clinical practice. This study aims to assess the prognostic significance of histological tumour length in potentially curative oesophageal resections for cancer. Materials and methods Patients with locally advanced oesophageal carcinoma (squamous or adenocarcinoma) were identified in a single centre between July 2000 and December 2016. Patient demographics, tumour characteristics and survival outcomes were assimilated. Unifactorial and multifactorial analysis was performed to assess tumour length correlation with oncological outcomes. Results A total of 281 patients were included; 226 (80.4%) male and 55 (19.6%) female, with a median age of 66 years; 39 patients (13.9%) developed local recurrence and 104 (37%) distant metastases. Disease progression rate was 44.8% with a median progression-free survival of 21 months and median overall survival of 30 months. Median tumour length was 3cm (interquartile range 2–4.5cm). Multivariate analysis demonstrated longer tumours to be significantly associated with a higher rate of local recurrence (p=0.028), metastases (p=0.016), disease progression (p=0.001) and shorter progression-free survival (p=0.001). Discussion This study demonstrates histological tumour length as an independent prognostic factor for local recurrence, metastases, disease progression and progression-free survival. Further larger multicentre studies are required to define the role of longitudinal tumour length as a marker to identify patients who are at higher risk of poor oncological outcomes following surgery.

Impact and Analysis of Prognostic Factors in Patients with Non-Metastatic Esophageal Squamous Cell Carcinoma: A Retrospective Single Institution Study

“…In this study, to clarify the impact of the length of the esophageal lesions on the survival rate of patients, we applied the ROC curve analysis method to define the specific cut-off values of the patients in this group. The results show that when the patient's lesion length is ≤4.5 cm, the patient survival rate, and local control rate are better than those patients with esophageal lesion length > 4.5 cm, which is similar to the results reported in the past [8] [9] [10] [11] [12].…”

Preliminary analysis of the benefits of different irradiation types on patients with postoperative locoregional recurrence of esophageal cell squamous carcinoma

“…The length of esophageal lesion and postoperative pathological staging are important factors affecting the prognosis of patients with EC after surgery (17). Most research results show that the lesion length of EC is closely related to the postoperative pathological stage T and N, and that patients with shorter lesions have relatively early T and N staging (18,19). According to the calculation formula of LODDS, it is clear that LODDS is related to the number of lymph nodes, with smaller LODDS correlating to the earlier stages of a patient's disease.…”

Competing risk nomogram to predict cancer‑specific survival in esophageal cancer during the intensity‑modulated radiation therapy era: A single institute analysis

“…Similarly, the present study demonstrated that tumor length was an important prognostic factor for the EC-SM of patients who underwent IMRT. Furthermore, although most studies supported that tumor length is an important prognostic factor for EC, no consensus was achieved on the tumor size cut-off value, which ranges from 2 to 5 cm (31)(32)(33). The results from the present study demonstrated that elevated 2-year EC-SM was observed in patients with tumor length ≥4.5 cm (45.8% vs. <4.5 cm group: 21.4%; P<0.001).…”