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 24 May 2018

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News

Determinants of survival in node-negative esophageal cancer

A study in December's issue of the British Journal of Surgery reports that surgical resection of node-negative esophageal cancer is associated with diverse long-term outcomes, but that this is not reflected in the tumor node metastasis (TNM)-based staging system.

News image

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Many studies have analyzed prognostic factors following esophagectomy, but few have examined survival determinants in node-negative (N0) esophageal cancer.

Dr Khan and colleagues undertook a study into the prognostic significance of a number of histological variables following surgical resection of N0 esophageal cancer.

The researchers reviewed the case notes of a total of 219 patients who were undergoing potentially curative esophagectomy for N0 squamous cell carcinoma or adenocarcinoma of the esophagus.

The research team noted the details of the patient's sex, age at operation, histological type, longitudinal tumor length, tumor (T) stage, circumferential resection margin involvement, tumor grade, presence of vascular invasion, perineural invasion, Barrett's metaplasia, and survival.

3 factors correlate with poor prognosis: T stage, adenocarcinoma and degree of differentiation
British Journal of Surgery

The researchers performed univariate and multivariate analyses to identify prognostic factors.

The researchers found on univariate analysis that 3 factors correlated with poor prognosis: T stage, adenocarcinoma and degree of differentiation.

In addition, the research team found that on multivariate analysis, all 3 were significant independent adverse prognostic indicators.

Dr Khan concluded, "Surgical resection of node-negative esophageal cancer is associated with diverse long-term outcomes."

"This diversity of outcome is not reflected in the tumor node metastasis (TNM)-based staging system."

"The utility of the TNM system in predicting prognosis after surgical resection is open to question."

British Journal of Surgery; 2004: 91 (12): 1586-91
24 November 2004

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