Prognostic factors for the survival of patients with esophageal carcinoma in the U.S.: the importance of tumor length and lymph node status.
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TLDR
The authors explored the effect of tumor length and number of positive lymph nodes on survival in patients with esophageal carcinoma using data from the National Cancer Institute SEER Program.Abstract:
BACKGROUND
The current TNM classification system does not consider tumor length or the number of lymph nodes in the staging and classification scheme for patients with esophageal carcinoma. Using data from the National Cancer Institute SEER Program, the authors explored the effect of tumor length and number of positive lymph nodes on survival in patients with esophageal carcinoma.
METHODS
Patients with esophageal adenocarcinoma or squamous cell carcinoma were subgrouped according to historic stage with localized, regional, or distant disease. Demographic factors (age at diagnosis, race, and gender) and tumor characteristics (morphology, histologic grade, tumor length, primary site, depth of invasion, number of positive lymph nodes, proportion of positive lymph nodes dissected, and distant metastatic sites) were examined.
RESULTS
Overall factors that were associated with an increased mortality risk included increasing age at diagnosis, black race versus white race, histologic grade, primary tumor site in the lower esophagus and abdomen versus upper regions, and increasing depth of invasion. Among patients with regional disease, the number of positive lymph nodes (≥ 5 vs. < 5) was related to an increasing risk (hazard ratio [HR], 1.29; 95% confidence interval [95%CI], 1.06–1.56). The proportion of positive lymph nodes compared with the number of lymph nodes dissected conferred an increased risk (HR, 1.63; 95%CI, 1.26–2.11). Among patients with distant disease, sites other than distant lymph nodes implied an increased mortality risk (HR, 1.37; 95%CI, 1.37–1.65). Tumor length was an independent predictor of mortality when controlling for depth of invasion in patients with localized disease (HR, 1.15; 95%CI, 1.08–1.21).
CONCLUSIONS
Tumor length, the number of involved lymph nodes, and the ratio of positive lymph nodes are important prognostic factors for survival in patients with esophageal carcinoma. A revised TNM classification system for patients with esophageal carcinoma might consider adding tumor length and number of positive lymph nodes as two important prognostic factors. Cancer 2002;95:1434–43. © 2002 American Cancer Society.
DOI 10.1002/cncr.10868read more
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References
More filters
Book
International Classification of Diseases for Oncology
TL;DR: This list of diseases for oncology includes cancers of the central nervous system, as well as other types of diseases such as lymphoma, leukaemia, and so on.
Journal ArticleDOI
Cancer statistics, 2001.
TL;DR: Estimates of the number of new cancer cases and deaths expected in the US in the current year and the most recent data on cancer incidence, mortality, and survival reveal large disparities in cancer incidence and mortality across racial/ethnic groups.
Journal ArticleDOI
International Classification of Diseases for Oncology
TL;DR: Use ofImmunofluorescence in the Diagnosis of Virus Infections using audio-tape slide programme and slides and cassette by P. S. Gardner.
Journal ArticleDOI
Rising incidence of adenocarcinoma of the esophagus and gastric cardia.
TL;DR: Cancer incidence data from nine areas of the United States revealed steadily rising rates from 1976 to 1987 of adenocarcinomas of the esophagus and gastric cardia, which disproportionately affected white men and rarely occurred among women.
Journal ArticleDOI
Continuing Climb in Rates of Esophageal Adenocarcinoma: An Update
TL;DR: The rate of esophageal adenocarcinoma in 1988 to 1990 was three times that in 1976 to 1978, while the rate of squamous cell carcinoma declined by 23%.