Staging of esophageal carcinoma: Length of tumor and number of involved regional lymph nodes. Are these independent prognostic factors?

Journal of Surgical Oncology - Tập 94 Số 5 - Trang 355-363 - 2006
Elfriede Bollschweiler1, Stephan Baldus2, Wolfgang Schroeder1, Paul M. Schneider1, A. H. Hölscher1
1Department of Visceral and Vascular Surgery, University of Cologne, Germany
2Institute of Pathology, University of Cologne, Germany

Tóm tắt

AbstractBackground and ObjectivesNew potential prognostic indicators aside from the TNM classification have been proposed. The aim of this study was to analyze the prognostic relevance of tumor length as well as number of involved regional lymph nodes (LNM) in patients with esophageal carcinoma.MethodsTwo hundred thirteen patients with esophageal carcinoma (116 squamous cell‐ and 97 adenocarcinoma) were included in this study. Treatment of choice was subtotal en bloc esophagectomy including “2‐field” lymphadenectomy. The median number of examined lymph nodes (LNs) was 28. Eighty patients (38%) received preoperative radio‐chemotherapy according to a standardized protocol. Histopathology consisted of tumor stage, residual tumor, grading, and number of examined and involved LN. Univariate and multivariate prognostic values were calculated.ResultsLength of tumor correlated with pT/ypT‐category (P < 0.01). Univariate but not multivariate analysis showed better survival for tumors ≤3 cm (P < 0.05). Patients with 1–5 LNM had significantly better prognoses than those with more than 5 LNM (Hazard ratio 2.7, 95% CI = 1.7–4.2) (P < 0.01). Patients without LNM and more than 15 examined LN showed significantly better prognosis than those with fewer examined LN (Hazard ratio = 0.3, 95% CI = 0.1–0.6) (P < 0.01).ConclusionsA revision of the TNM classification for esophageal carcinoma should subdivide the pN1‐category according to the number of LNM. J. Surg. Oncol. 2006;94:355–363. © 2006 Wiley‐Liss, Inc.

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Journal of Surgical Oncology

Tập 94 Số 5

355-363

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