title: Impact of tumor length on survival for patients with resected esophageal cancer.
abstract: BACKGROUND
  Tumor length in patients with esophageal cancer (EC) has recently received great attention. However, its prognostic role for EC is controversial. The purpose of our study was to characterize the prognostic value of tumor length in EC patients and offer the optimum cut-off point of tumor length by reliable statistical methods.
  
  
  METHODS
  A retrospective analysis was conducted on 71 consecutive patients with EC who underwent surgery. ROC curve analysis was used to determine the optimal cut-off point for tumor length, measured with a handheld ruler after formalin fixation. Correlations between tumor length and other factors were surveyed, and overall survival (OS) rates were compared between the two groups. Potential prognostic factors were evaluated by univariate Kaplan-Meier survival analysis. A P value less than 0.05 was considered significant.
  
  
  RESULTS
  There were a total of 71 patients, with a male/ female divide of 43/28 and a median age of 59. Characteristics were as follows: squamous/adenocarcinoma, 65/6; median tumor length, 4 (0.9-10); cut-off point for tumor length, 4cm. Univariate analysis prognostic factors were tumor length and modality of therapy. One, three and five year OS rates were 84, 43 and 43% for tumors with ≤4cm length, whereas the rates were 75, 9 and 0% for tumors >4 cm. There was a significant association between tumor length and age, sex, weight loss, tumor site, histology, T and N scores, differentiation, stage, modality of therapy and longitudinal margin involvement.
  
  
  CONCLUSIONS
  Future studies for modification of the EC staging system might consider tumor length too as it is an important prognostic factor. Further assessment with larger prospective datasets and practical methods (such as endoscopy) is needed to establish an optimal cut-off point for tumor length.
authors.affiliation: Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran E-mail : dr.somi.m.h@gmail.com.
authors.forename: Seyed Kazem
authors.initials: SK
authors.lastname: Mirinezhad
authors.forename: Amir Ghasemi
authors.initials: AG
authors.lastname: Jangjoo
authors.forename: Farshad
authors.initials: F
authors.lastname: Seyednejad
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Naseri
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mohammadzadeh
authors.forename: Behnam
authors.initials: B
authors.lastname: Nasiri
authors.forename: Amir Taher
authors.initials: AT
authors.lastname: Eftekharsadat
authors.forename: Sara
authors.initials: S
authors.lastname: Farhang
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Somi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden