Clinical Significance Of Measurement Of Tumor Volume In Patients With Nonoperative Esophageal Squamous Cell Carcinoma Based On CT

Objective:To explore the clinical significance of tumor volume measurement based on CT in patients with non-surgical esophageal squamous cell carcinoma and the rationality of T-staging,and as well to compare the difference between T-stage and AJCC staging system in the eighth edition.Designed to develop a more convenient and applicable clinical staging system for patients with non-operative esophageal squamous cell carcinoma in order to better guide the treatment plan and judge the prognosis.Materials and methods:This retrospective study enrolled 158 patients with non-operative esophageal squamous cell carcinoma diagnosed by pathology in The First Affiliated Hospital Of Guangxi Medical University.The tumor volume was calculated according to CT images,optimal cut-off point value of tumor volume was obtained with x-tile and T staging was redefined.Kaplan-meier method was used for univariate analysis and comparison of survival period,and survival curve was drawn.Log-rank was used to test the survival curve,COX regression model was used for multivariate analysis for the purpose to explore its guiding significance for prognosis.Results:The 3-year survival rate in the whole group was 39.0%,After calculating by X-tile software,The tumor volume value of 12.7 cm~3、22.8 cm~3、51.9 cm~3 were selected as the cut-off point of T stage.The tumor volume staging criteria were divided into T1(tumor volume<12.7 cm~3),T2(12.7 cm~3≤tumor volume<22.8 cm~3),T3(22.8 cm~3≤tumor volume<51.9 cm~3)and T4(tumor volume≥51.9 cm~3).There were significant differences in survival rate among T staging subgroups after the use of new T staging(P<0.01),In the univariate analysis,chemotherapy,alcohol consumption,tumor length,tumor length at the largest tumor level,tumor short diameter at the largest tumor level,8th T stage and Proposed T stage were prognostic predictors.While in multivariate analysis,chemotherapy and Proposed T stage are independent prognostic factors affecting the prognosis,Comparing the AJCC/UICC 8th edition and proposed T staging system,the‘-2 Log Likelihood’of the 8th edition and proposed staging system respectively was 1068.060 and 1047.418.The difference in Akaike information criterion(AIC)between the 8th edition and the proposed staging system was18.642.Conclusion:The new T staging based on CT measurement of tumor volume can accurately predict the prognosis of patients with non-surgical esophageal squamous cell carcinoma.Moreover,the operational convenience in the clinic is stronger than that in the AJCC stage system,and its predicted ability appears to be superior,but a large number of cases are still required.