Clinicopathological parameters predicting recurrence of pT1N0 esophageal squamous cell carcinoma

作     者：Li-Yan Xue Xiu-Min Qin Yong Liu Jun Liang Hua Lin Xue-Min Xue Shuang-Mei Zou Mo-Yan Zhang Bai-Hua Zhang Zhou-Guang Hui Zi-Tong Zhao Li-Qun Ren Yue-Ming Zhang Xiu-Yun Liu Yan-Ling Yuan Jian-Ming Ying Shu-Geng Gao Yong-Mei Song Gui-Qi Wang Sanford M Dawsey Ning Lu 

作者机构：Department of Pathology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Center for Cancer Precision Medicine Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Endoscopy National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Medical Record National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Thoracic Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College The 2nd Department of Thoracic Surgery Hunan Cancer Hospital The Affiliated Cancer Hospital of Xiangya School of Medicine CSU State Key Laboratory of Molecular Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Pathology Chengde Medical College Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第45期

页      面：5154-5166页

核心收录：

学科分类：10[医学] 

基　　金：the National Natural Science Foundation of China,No.81402463 CAMS Innovation Fund for Medical Sciences(CIFMS),No.2016-I2M-1-001 and No.2016-I2M-3-005 the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences,No.2016ZX310178 and No.2017PT32001 

主　　题：Esophageal squamous cell carcinoma Tumor recurrence Lymph node negative esophageal cancer Recurrence-free survival Clinicopathological parameters 

摘      要：AIM To identify the clinicopathological characteristics of pT1 N0 esophageal squamous cell carcinoma(ESCC) that are associated with tumor recurrence. METHODS We reviewed 216 pT1 N0 thoracic ESCC cases who underwent esophagectomy and thoracoabdominal two-field lymphadenectomy without preoperative chemoradiotherapy. After excluding those cases with clinical follow-up recorded fewer than 3 mo and those who died within 3 mo of surgery, we included 199 cases in the current analysis. Overall survival and recurrencefree survival were assessed by the Kaplan-Meier method, and clinicopathological characteristics associated with any recurrence or distant recurrence were evaluated using univariate and multivariate Cox proportional hazards models. Early recurrence(≤ 24 mo) and correlated parameters were assessed using univariate and multivariate logistic regression *** Forty-seven(24%) patients had a recurrence at 3 to 178(median, 33) mo. The 5-year recurrence-free survival rate was 80.7%. None of 13 asymptomatic cases had a recurrence. Preoperative clinical symptoms, upper thoracic location, ulcerative or intraluminal mass macroscopic tumor type, tumor invasion depth level, basaloid histology, angiolymphatic invasion, tumor thickness, submucosal invasion thickness, diameter of the largest single tongue of invasion, and complete negative aberrant p53 expression were significantly related to tumor recurrence and/or recurrence-free survival. Upper thoracic tumor location, angiolymphatic invasion, and submucosal invasion thickness were independent predictors of tumor recurrence(Hazard ratios = 3.26, 3.42, and 2.06, P 0.001, P 0.001, and P = 0.002, respectively), and a nomogram for predicting recurrence-free survival with these three predictors was constructed. Upper thoracic tumor location and angiolymphatic invasion were independent predictors of distant recurrence. Upper thoracic tumor location, angiolymphatic invasion, submucosal invasion thickness, and diameter o