Impact of lymph node involvement in T2 or T3 thoracic esophageal squamous cell carcinoma.
OBJECTIVE
Treatment strategy for T2/ T3 esophageal carcinoma has become controversial because of recent improvements in chemoradiation therapy. Only a few study analyzed the prognostic impact of clinicopathological factors for surgical outcome of patients with esophageal carcinoma focused on T2/T3 tumors.


METHODS
Subjects of this study were 187 patients with pathological T2 (n = 46) or pathological T3 (n = 141) thoracic esophageal squamous cell carcinoma who received surgical treatment without neoadjuvant therapy. The impact of clinicopathological factors on survival was evaluated by univariate and multivariate analysis.


RESULTS
Overall 5-year survival rate of all patients was 38%. Dismal 5-year overall survival rates were observed in patients with 5 or more positive nodes (11%). Multivariate analysis indicated that lymph node metastases (hazard ratio; 2.07, 95%IC, 1.20-3.56, p < 0.01) and the number of metastatic nodes (hazard ratio; 1.77, 95%IC, 1.11-2.82, p = 0.02) were independent risk factors for poor survival. However, tumor depth itself was not an independent risk factor for survival.


CONCLUSIONS
Although survival of patients with pathological T2 or T3 was partly dependent on tumor depth, it was mainly dependent on lymph node status. Multiple positive nodes were independent risk factors for poor survival.
Shimada
Hideaki
H
Division of Gastroenterological Surgery, Chiba Cancer Center, 666-2 Nitona-Chou, Chuou-ku, Chiba 260-8717, Japan. hshimada@faculty.chiba-u.jp
Okazumi
Shinichi
S
Shiratori
Tooru
T
Akutsu
Yasunori
Y
Matsubara
Hisahiro
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate