Do Tumor Grade and Location Affect Survival in Esophageal Squamous Cell Carcinoma? Survival Analysis of 302 Cases of pT3N0M0 Esophageal Squamous Cell Carcinoma
Do Tumor Grade and Location Affect Survival in Esophageal Squamous Cell Carcinoma? Survival Analysis of 302 Cases of pT3N0M0 Esophageal Squamous Cell Carcinoma
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DOI：
10.1245/s10434-012-2656-0
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发表时间：
2013-02-01
影响因子：
3.7
通讯作者：
Ma, Guowei
中科院分区：
文献类型：
--
作者：
Situ, Dongrong;Wei, Weidong;Ma, Guowei
第7版美国癌症联合委员会（AJCC）癌症分期手册纳入了pT 2 - 3 N 0 M0食管鳞状细胞癌分期的肿瘤分级和位置。根据AJCC癌症分期手册第6版分类为IIa期的pT 3 N 0 M0患者，现在可以分类为Ib、IIa或IIb期。我们回顾性分析了1990年至2005年在中山大学肿瘤防治中心接受食管切除术的302例术后病理分期为T3 N 0 M0的患者，旨在探讨这些变化是否影响生存率并确定其他潜在的预后因素。我们进行了单因素和多因素分析，以确定生存的预后因素，并使用Kaplan-Meier方法比较生存差异的每个预后因素，包括肿瘤的分级和位置。5年总生存率为46%，中位生存期为1，244.5天。在单变量和多变量分析中，性别、年龄、饮酒、第一秒用力呼气量（FEV 1）和淋巴结切除数量是独立的预后因素。在Kaplan-Meier法生存分析中，吸烟也是一个预后因素。年龄、性别、饮酒量、FEV 1、淋巴结清扫数和吸烟是pT 3 N 0 M0食管鳞癌患者的独立预后因素。然而，肿瘤分级和位置可能不是这些患者的强预测因子，如AJCC癌症分期手册第7版所示。
The 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual incorporates tumor grade and location for staging pT2-3N0M0 esophageal squamous cell carcinoma. Patients with pT3N0M0, classified as stage IIa according to the 6th edition of the AJCC cancer staging manual, can now be classified as stage Ib, IIa, or IIb. We aimed to discuss whether these changes affect survival and determine other potential prognostic factors.We retrospectively analyzed 302 patients with postoperative pathologic stage T3N0M0 who underwent esophagectomy between 1990 and 2005 at Sun Yat-sen University Cancer Center. We performed univariate and multivariate analyses to identify prognostic factors for survival and used the Kaplan-Meier method to compare survival difference in each prognostic factor, including tumor grade and location.The 5-year overall survival rate was 46 %, with a median survival of 1,244.5 days. Gender, age, alcohol consumption, forced expiratory volume in 1 s (FEV1), and number of removed lymph nodes were independent prognostic factors in both univariate and multivariate analyses. Smoking was also a prognostic factor in survival analysis by the Kaplan-Meier method. However, histologic tumor grade and location had no significant influence on patient survival.Age, gender, alcohol consumption, FEV1, number of removed lymph nodes, and cigarette smoking are independent prognostic factors in patients with pT3N0M0 esophageal squamous cell carcinoma. However, tumor grade and location may not be as strong predictors in these patients as indicated in the 7th edition of the AJCC cancer staging manual.