Endscopic Length As A Prognostic Factor In Patients With Esophageal Cancer

The objective of the current study was to investigate the value ofendoscopically measured tumor length in predicting overall survival in patients withesophageal cancer.METHODS: We retrospectively analyzed the clinical records of169patients witheshohageal cancer who underwent radical resection in our hospital from July2009toDecember2010. Receiver-operating characteristic (ROC) curve analysis was used todetermine the appropriate cutoff value for endoscopic tumor length. Based on thiscutoff value, patients were divided into two groups: those with long-length tumor(LLTs) and those with short-length tumors (SLTs). The correlations between otherclinicopathologic factors and endoscopic tumor were investigated, and the3-yearoverall survival (OS) rate was compared between the two groups. Potential prognosticfactors were evaluated by univariate Kaplan-Meier survival analysis and multivariateCox’s proportional hazard model analysis.RESULTS: ROC analysis indicated that the sensitivity and specificity results for theappropriate endoscopic tumor length cutoff value of5.5cm were32.4%and10.7%,respectively. Using this cutoff value,30patients (17.8%) were LLTs (endoscopic tumerlength≥5.5cm) and139(82.2%) were SLTs (endoscopic tumer length <5.5cm). LLTshad a significantly lower3-year OS rate than those with SLTs (45.0%vs.76.5%).Univariate analysis revealed that the factors affecting the prognostic includedendosopic tumor margin, endoscopic tumor length, lymphatic tumor emboli,numberof lymph node metastasis,histopathological type.Multivariate analysis revealed thatendoscopic tumor length, lymphatic tumor emboli,number of lymph node metastasiswere independent prognostic factors. In patients without lymphatic tumor emboli,3-year OS rates were significantly lower for LLTs than for SLTs (79.3%vs.47.4%, P<0.005).CONCLUSION: Using a endoscopic tumer length cutoff value of5.5cm, endoscopic tumer length is a prognostic factor in patients with esophageal cancer.There was poorer prognosis in esophageal cancer patients without lymphatic tumoremboli, especially when endoscopic tumer length≥5.5cm.