JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
William D. Bolton
Wayne L. Hofstetter
Reza J. Mehran
David C. Rice
Jack A. Roth
Ara A. Vaporciyan
Garrett L. Walsh
Stephen G. Swisher
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Bolton, W. D.
Right arrow Articles by Swisher, S. G.
PubMed
Right arrow Articles by Bolton, W. D.
Right arrow Articles by Swisher, S. G.
Related Collections
Right arrow Esophagus - cancer

J Thorac Cardiovasc Surg 2009;138:831-836
© 2009 The American Association for Thoracic Surgery

General Thoracic Surgery

Impact of tumor length on long-term survival of pT1 esophageal adenocarcinoma

William D. Bolton, MDa, Wayne L. Hofstetter, MDa, Ashleigh M. Francis, BSa, Arlene M. Correa, MDa, Jaffer A. Ajani, MDb, Manoop S. Bhutani, MDc, Jeremy Erasmus, MDd, Ritsuko Komaki, MDe, Dipen M. Maru, MDf, Reza J. Mehran, MDa, David C. Rice, MDa, Jack A. Roth, MDa, Ara A. Vaporciyan, MDa, Garrett L. Walsh, MDa, Stephen G. Swisher, MDa,*

a Department of Thoracic and Cardiovascular Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Tex
b Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Tex
c Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Tex
d Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center, Houston, Tex
e Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Tex
f Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Tex

Received for publication May 9, 2008; revisions received January 16, 2009; accepted for publication February 2, 2009.

* Address for reprints: Stephen G. Swisher, MD, The University of Texas M. D. Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, 1515 Holcombe Blvd, Box 445, Houston, TX 77030. (Email: sswisher{at}mdanderson.org).

Introduction: The impact of esophageal tumor length on pT1 esophageal adenocarcinoma has not been well evaluated.

Methods: Case histories of all patients (n = 133) undergoing esophageal resection from 1979 to 2007 with pT1 adenocarcinoma of the esophagus were reviewed. Univariate and multivariate analyses of esophageal tumor length and other standard prognostic factors were performed.

Results: Patients with early-stage pT1 esophageal adenocarcinoma with tumors less than 3 cm demonstrate decreased long-term survival (3 years: >3 cm = 46% vs 93%; P < .001) and higher risk of lymph node involvement (lymph node positive: >3 cm = 47% vs 10%; P < .001). Multivariable analysis shows that esophageal tumor length (>3 cm) is an independent risk factor for survival in patients with pT1 early-stage esophageal cancer (hazard ratio: 4.8, 95% confidence intervals: 1.4–16.5; P < .001) even when controlled for submucosal involvement, lymph node involvement, and lymphatic/vascular invasion status. In combination with submucosal involvement, esophageal tumor length (>3 cm) identifies a high-risk population of pT1 esophageal adenocarcinoma (3 years: group 1 [0 risk factors] = 100%, group 2 [1 risk factor] = 87%, and group 3 [2 risk factors] = 33%; P < .001).

Conclusions: This study demonstrates that esophageal tumor length (>3 cm) is a risk factor for long-term survival and lymph node involvement in early-stage pT1 esophageal adenocarcinoma. Esophageal tumor length (>3 cm) in combination with submucosal involvement may help to identify a high-risk group of patients with pT1 esophageal adenocarcinoma.

Abbreviations and Acronyms CI = confidence intervals; CT = computed tomography; HR = hazard ratio; LVI = lymphatic/vascular invasion; MDACC = M. D. Anderson Cancer Center; PET = positron emission tomography






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The American Association for Thoracic Surgery.