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Endoscopic Tumor Length Should Be Reincluded in the Esophageal Cancer Staging System: Analyses of 662 Consecutive Patients.

Valmasoni M, Pierobon ES, Ruol A, De Pasqual CA, Zanchettin G, Moletta L, Salvador R, Costantini M, Merigliano S - PLoS ONE (2016)

Bottom Line: New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies.Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer.Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.

View Article: PubMed Central - PubMed

Affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.

ABSTRACT
Esophageal cancer represents the 6th cause of cancer mortality in the World. New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies. Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer. Recently, trying to better select patients with curing possibilities several authors are reconsidering tumor length as a valuable prognostic parameter. Specifically, endoscopic tumor length can be easily measured with an esophageal endoscopy and, if its utility in esophageal cancer staging is demonstrated, it may represent a simple method to identify high risk patients and an easy-to-obtain variable in prognostic stratification. In this study we retrospectively analyzed 662 patients treated for esophageal cancer, stratified according to cancer histology and current staging system, to assess the possible role of endoscopic tumor length. We found a significant correlation between endoscopic tumor length, current staging parameters and 5-year survival, proving that endoscopic tumor length may be used as a simple risk stratification tool. Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.

No MeSH data available.


Related in: MedlinePlus

Study cohort with groups and subgroups.N: number of patients; S: Endoscopic Tumor Length < 3 cm; L: Endoscopic Tumor Length ≥ 3 cm; SCC: squamous cell carcinoma; AC: adenocarcinoma.
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pone.0153068.g001: Study cohort with groups and subgroups.N: number of patients; S: Endoscopic Tumor Length < 3 cm; L: Endoscopic Tumor Length ≥ 3 cm; SCC: squamous cell carcinoma; AC: adenocarcinoma.

Mentions: Optimal cutoff of ETL was identified with a regression tree survival analysis, comparison between survival curves plotted for ETL intervals of 1 cm and the literature review. Patients, overall and in the groups and subgroups, were then analyzed based on the ETL cutoff (S, short tumor; L, long tumor), (Fig 1).


Endoscopic Tumor Length Should Be Reincluded in the Esophageal Cancer Staging System: Analyses of 662 Consecutive Patients.

Valmasoni M, Pierobon ES, Ruol A, De Pasqual CA, Zanchettin G, Moletta L, Salvador R, Costantini M, Merigliano S - PLoS ONE (2016)

Study cohort with groups and subgroups.N: number of patients; S: Endoscopic Tumor Length < 3 cm; L: Endoscopic Tumor Length ≥ 3 cm; SCC: squamous cell carcinoma; AC: adenocarcinoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835067&req=5

pone.0153068.g001: Study cohort with groups and subgroups.N: number of patients; S: Endoscopic Tumor Length < 3 cm; L: Endoscopic Tumor Length ≥ 3 cm; SCC: squamous cell carcinoma; AC: adenocarcinoma.
Mentions: Optimal cutoff of ETL was identified with a regression tree survival analysis, comparison between survival curves plotted for ETL intervals of 1 cm and the literature review. Patients, overall and in the groups and subgroups, were then analyzed based on the ETL cutoff (S, short tumor; L, long tumor), (Fig 1).

Bottom Line: New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies.Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer.Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.

View Article: PubMed Central - PubMed

Affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.

ABSTRACT
Esophageal cancer represents the 6th cause of cancer mortality in the World. New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies. Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer. Recently, trying to better select patients with curing possibilities several authors are reconsidering tumor length as a valuable prognostic parameter. Specifically, endoscopic tumor length can be easily measured with an esophageal endoscopy and, if its utility in esophageal cancer staging is demonstrated, it may represent a simple method to identify high risk patients and an easy-to-obtain variable in prognostic stratification. In this study we retrospectively analyzed 662 patients treated for esophageal cancer, stratified according to cancer histology and current staging system, to assess the possible role of endoscopic tumor length. We found a significant correlation between endoscopic tumor length, current staging parameters and 5-year survival, proving that endoscopic tumor length may be used as a simple risk stratification tool. Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.

No MeSH data available.


Related in: MedlinePlus