title: Factors predictive of prognosis after esophagectomy for squamous cell cancer.
abstract: OBJECTIVE
  To evaluate the prognosis after esophagectomy for squamous cell carcinoma of the thoracic esophagus and its prognostic factors.
  
  
  METHODS
  Six hundred five patients with primary squamous cell carcinoma of the thoracic esophagus who underwent curative esophagectomy between June 1997 and June 1998 were collected from 3 medical centers. Among them, 26 patients died from the operation and 26 patients did not complete adjuvant treatment owing to toxicity. Univariate and multivariate analysis was performed to identify prognostic factors for survival. The effect of adjuvant treatment on survival was also evaluated.
  
  
  RESULTS
  The 1-, 3-, 5-, and 10-year overall survivals of 605 patients were 90%, 65%, 36%, and 8%, respectively. Multivariate analysis identified the following as independent prognostic factors: number of lymph node metastases (P < .001), histologic differentiation (P < .001), tumor location (P = .002), depth of invasion (P = .020), and vascular invasion (P = .023).
  
  
  CONCLUSIONS
  Several pathologic characteristics of the primary tumor are correlated with the outcome of esophagectomy for squamous carcinoma of the thoracic esophagus. Patients with fewer than 2 metastatic nodes after curative esophagectomy have a better prognosis than those with multiple involved nodes (>2). To stratify patients appropriately for prognosis, it is necessary to refine the current 6th edition TNM staging system.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Jiangsu Province Tumor Hospital, Nanjing, China. lihouhuai@vip.163.com
authors.forename: Houhuai
authors.initials: H
authors.lastname: Li
authors.forename: Qingzhen
authors.initials: Q
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.forename: Yijiang
authors.initials: Y
authors.lastname: Chen
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wei
authors.forename: Guoren
authors.initials: G
authors.lastname: Zhou
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate