title: Endoscopic tumor length is an independent prognostic factor in esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  To investigate the impact of endoscopic esophageal tumor length on survival for patients with resected esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  We retrospectively reviewed the clinicopathologic characteristics of 244 ESCC patients who underwent curative resection as the primary treatment at Taipei Veterans General Hospital between January 2000 and November 2010. The endoscopic tumor length was defined as a uniform measurement before completion of the esophagectomy. The impact of endoscopic tumor length on a patient's overall survival (OS) and disease-free survival (DFS) were assessed. A Cox regression model was used to identify prognostic factors.
  
  
  RESULTS
  The 1-, 3-, and 5-year OS rates were 81.2, 48.2, and 39.6%, respectively, with a median survival time of 18.0 months. The 1-, 3-, and 5-year DFS rates were 66.2, 34.7, and 32.4%, respectively, with a median DFS of 15.0 months. Endoscopic tumor length correlated with pathologic tumor length [Pearson correction (r)=0.621; P<0.001] Regression trees analyses suggested an optimum cutoff point of >4 cm to identify patients with decreased long-term survival. In multivariate survival analysis, endoscopic tumor length (more or less than 4 cm) remained an independent prognostic factor for both OS (P=0.006) and DFS (P=0.002).
  
  
  CONCLUSIONS
  Endoscopic tumor length could have a significant impact on both the OS and DFS of patients with resected ESCC and may provide additional prognostic value to the current tumor, node, and metastasis staging system before patients receive any cancer-specific treatment.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, and Chung Shan Medical University, Taichung, Taiwan. bywang1@gmail.com
authors.forename: Bing-Yen
authors.initials: BY
authors.lastname: Wang
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Ching-Hsiung
authors.initials: CH
authors.lastname: Lin
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.forename: Ching-Yuan
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate