title: Endoscopic Tumor Length Should Be Reincluded in the Esophageal Cancer Staging System: Analyses of 662 Consecutive Patients.
abstract: Esophageal cancer represents the 6th cause of cancer mortality in the World. New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies. Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer. Recently, trying to better select patients with curing possibilities several authors are reconsidering tumor length as a valuable prognostic parameter. Specifically, endoscopic tumor length can be easily measured with an esophageal endoscopy and, if its utility in esophageal cancer staging is demonstrated, it may represent a simple method to identify high risk patients and an easy-to-obtain variable in prognostic stratification. In this study we retrospectively analyzed 662 patients treated for esophageal cancer, stratified according to cancer histology and current staging system, to assess the possible role of endoscopic tumor length. We found a significant correlation between endoscopic tumor length, current staging parameters and 5-year survival, proving that endoscopic tumor length may be used as a simple risk stratification tool. Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Michele
authors.identifier: http://orcid.org/0000-0002-1462-8275
authors.initials: M
authors.lastname: Valmasoni
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Elisa Sefora
authors.initials: ES
authors.lastname: Pierobon
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruol
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: De Pasqual
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Gianpietro
authors.initials: G
authors.lastname: Zanchettin
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Moletta
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Salvador
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Costantini
authors.affiliation: 3rd Surgical Clinic - Center for Esophageal Disease, Department of Surgical, Oncological and Gastroenterological Sciences, University Hospital of Padova, Padova 35128, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Merigliano
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies