Tumour size of resectable oesophageal squamous cell carcinoma measured with multidetector computed tomography for predicting regional lymph node metastasis and N stage.
OBJECTIVE
To determine whether and how tumour size of resectable oesophageal squamous cell carcinoma (ESCC) measured with multidetector CT could predict regional lymph node metastasis (LNM) and N stage.


METHODS
Two hundred five patients with ESCC underwent radical oesophagectomy with three-field lymphadenectomy less than 3 weeks after contrast-enhanced CT. Tumour size of the ESCC (tumour length, maximal thickness and gross tumour volume, GTV) was measured on CT. Statistical analyses were performed to identify whether tumour size could predict regional LNM and N stage, and to determine how to use the size of ESCC to predict N stage.


RESULTS
Univariate analysis showed that tumour size could predict regional LNM (all P < 0.05). Logistic regression analysis revealed that GTV could independently predict regional LNM (P = 0.021, odds ratio = 1.813). Mann-Whitney tests showed that tumour size could distinguish grouped N stages (all P < 0.05). GTV might be a differentiating indicator between N0 and N1-3 stages (cutoff, 14.4 cm(3)), between N0-1 and N2-3 (cutoff, 15.9 cm(3)), and between N0-2 and N3 (cutoff, 26.1 cm(3)), with sensitivity of 76%, 63% or 75%, and specificity of 75%, 61% and 81%, respectively.


CONCLUSIONS
The GTV of ESCC measured with CT could be an indicator for predicting regional LNM and grouped N stages.


CONCLUSIONS
• Multidetector computed tomography (MDCT) allows accurate assessment of oesophageal tumour size                                  • For resectable squamous cell tumours, size helped predict regional lymph node involvement                                  • Gross tumour volume may predict the N stage of oesophageal squamous cell carcinoma.
Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Shunqing District, Nanchong, 637000, Sichuan, China.
Hang
H
Li
Tian-wu
TW
Chen
Zhen-lin
ZL
Li
Xiao-ming
XM
Zhang
Xiao-li
XL
Chen
Li-ying
LY
Wang
Li
L
Zhou
Rui
R
Li
Chun-ping
CP
Li
Xiao-hua
XH
Huang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology*; D015331:Cohort Studies; D003287:Contrast Media / Q000494:pharmacology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D061330:Multidetector Computed Tomography / Q000379:methods*; D015999:Multivariate Analysis; D015588:Observer Variation; D012372:ROC Curve
D003287:Contrast Media