title: Potential of Baseline Computed Tomography to Predict Long-Term Survival of Patients With Locally Advanced Esophageal Cancer Treated With Preoperative Chemotherapy: A Retrospective Cohort Study.
abstract: In this study, we evaluated the efficacy of baseline computed tomography (CT) signs and postoperative TN stages on survival of patients with advanced esophageal squamous cell carcinoma with preoperative chemotherapy. Consecutive patients (n = 130) with preoperative chemotherapy and radical esophagectomy from January 2006 to December 2011 were enrolled in this study retrospectively. Pathological T and N stages were confirmed by surgery. Baseline CT signs of tumor length, tumor thickness, outer membrane features, total number of lymph node (tLN), short diameter of the largest lymph node (SDL), and clinical T and N stages were measured. Eight-year overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier and Cox proportional hazards regression analyses to determine associations between baseline CT signs and survival outcomes. Kaplan-Meier analysis showed that tLN number, largest LN short axis diameter, pT, and pN stages all correlated with OS significantly. And the total tLN number, SDL and pN stages significantly correlated with DFS. In Cox analyses, total tLN number (>6) and pN stage were significantly associated with OS (hazard ratio [HR]: 1.55 [95% CI, 1.13-2.11, P = 0.006] and HR: 1.49 [95% CI, 1.17-1.90, P = 0.001], respectively). Cox regression analysis showed that OS index was predictive of 1- to 3-year survival. Total number of lymph node in baseline CT provides equal efficiency compared to pN stages in the prediction of 8-year long-term survival outcomes for advanced esophageal squamous cell carcinoma patients with preoperative chemotherapy.
authors.affiliation: From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology (Z-LW, YC, X-TL, Y-SS); and Department of Thoracic Surgery (K-NC), Peking University Cancer Hospital and Institute, Haidian District, Beijing, China.
authors.forename: Zhi-Long
authors.initials: ZL
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Li
authors.forename: Ke-Neng
authors.initials: KN
authors.lastname: Chen
authors.forename: Ying-Shi
authors.initials: YS
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D017239:Paclitaxel; D002945:Cisplatin