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Clinicopathologic Features of Submucosal Esophageal Squamous Cell Carcinoma
- Source :
- The Annals of Thoracic Surgery. 104:1858-1864
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background The prognoses of submucosal esophageal squamous cell carcinoma patients vary. Patients with favorable prognoses may receive less invasive or nonsurgical interventions, whereas patients with poor prognoses or advanced esophageal cancer may require aggressive treatments. We sought to identify prognostic factors for patients with submucosal esophageal squamous cell carcinoma, focusing on lymph node metastasis and recurrence. Methods We included 137 submucosal esophageal squamous cell carcinoma patients who had undergone transthoracic esophagectomy with systematic extended lymph node dissection. Submucosal tumors were classified as SM1, SM2, and SM3 according to the depth of invasion. Prognostic factors were determined by univariable and multivariable analyses. Results Lymph node metastasis was observed in 18.8%, 30.5%, and 50.0% of SM1, SM2, and SM3 cases, respectively. The overall 5-year recurrence rate was 21.9%; the rates for SM1, SM2, and SM3 tumors were 9.4%, 18.6%, and 34.8%, respectively. The SM1 tumors all recurred locoregionally; distant metastasis occurred in SM2 and SM3 cases. The 5-year overall survival rates were 83%, 77%, and 59% for SM1, SM2, and SM3 cases, respectively. On univariable analysis, lymph node metastasis, depth of submucosal invasion (SM3 versus SM1/2), and tumor location (upper thoracic versus mid/lower thoracic) were poor prognostic factors for overall survival. Multivariable Cox regression analyses identified depth of submucosal invasion (hazard ratio 2.51, 95% confidence interval: 1.37 to 4.61) and tumor location (hazard ratio 2.43, 95% confidence interval: 1.18 to 4.63) as preoperative prognostic factors. Conclusions Tumor location (upper thoracic) and infiltration (SM3) are the worse prognostic factors of submucosal esophageal squamous cell carcinoma, but lymph node metastasis is not a predictor of poorer prognosis.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Oncology
medicine.medical_specialty
Esophageal Mucosa
Esophageal Neoplasms
medicine.medical_treatment
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Carcinoma
Humans
Survival rate
Lymph node
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
Proportional hazards model
business.industry
Hazard ratio
Retrospective cohort study
Middle Aged
Prognosis
medicine.disease
Confidence interval
Esophagectomy
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
Carcinoma, Squamous Cell
Lymph Node Excision
Female
030211 gastroenterology & hepatology
Surgery
Esophageal Squamous Cell Carcinoma
Lymph Nodes
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....446ddf057ed322e0fea8329e4e616e2e