Multivariate analysis of clinicopathological factors influencing survival following esophagectomy for cancer.
BACKGROUND
A number of clinicopathological characteristics can influence survival following esophagectomy for cancer. The aim of this study was to determine the factors affecting survival in a consecutive series of patients undergoing esophagectomy for cancer at a single tertiary centre over a 7 year period.


METHODS
We analyzed a prospective database of 314 consecutive patients (247 males and 67 females), with a mean age of 62.8 +/- 9.1 years, who underwent esophagectomy for cancer at a single, high-volume centre between January 2000 and June 2007. The impact of 11 variables on survival following esophagectomy was determined by univariate and multivariate analysis.


RESULTS
On univariate analysis, gender, ASA grade, blood transfusion, type of cancer, tumor stage, lymph node status, lymphovascular invasion (LVI), longitudinal resection margin (LRM) involvement and circumferential resection margin (CRM) involvement were significant (p<0.05) negative factors for survival. Multivariate analysis using Cox proportional hazard regression demonstrated that the only independent factors negatively impacting on survival were ASA grade (p=0.012), tumor stage (p=0.009), LVI (p=0.009) and LRM involvement (p=0.031).


CONCLUSIONS
In the current study we demonstrated that independent variables effecting survival after esophagectomy for cancer were ASA grade, tumor stage, lymphovascular invasion and longitudinal resection margin involvement. Contrary to other studies we did not find CRM involvement to be an independent predictor for survival.
Mirnezami
Reza
R
Department of Surgery, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK. reza_mirnezami@yahoo.com
Rohatgi
Ashish
A
Sutcliffe
Robert P
RP
Hamouda
Ahmed
A
Chandrakumaran
Kandiah
K
Botha
Abrie
A
Mason
Robert C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis