Article Abstract

Prognostic value of tumor length in predicting survival for patients with esophageal cancer

Authors: Haijing Wang, Liangwen Bi, Lizhen Zhang, Weiyong Zhao, Min Yang, Xinchen Sun

Abstract

Background: To determine the prognostic value of tumor length in predicting overall survival (OS) for patients with esophageal cancer.
Methods: Patients who were diagnosed with esophageal cancer between 2010 and 2014 were identified from the Surveillance Epidemiology and End Results (SEER) data. We performed Kaplan-Meier survival analysis and developed a Cox regression proportional hazard model to explore the effect of tumor length on survival.
Results: A total of 6,897 esophageal cancer patients were identified. The patients were classified according to tumor length: 2,334 patients had a tumor length ≤3 cm, and 4,563 patients had a tumor length >3 cm. Patients with a tumor length >3 cm were more likely to have poorer histological grade (P<0.0001) and advanced T (P<0.0001), N (P<0.0001) or M (P<0.0001) stage compared to patients with a tumor length ≤3 cm. A greater risk of mortality was observed in patients with a tumor length >3 cm than in those with a tumor length ≤3 cm both in the Cox regression univariate analysis [hazard ratio (HR): 1.790; 95% CI: 1.667–1.922; P=0.000] and the multivariate analysis (HR: 1.447; 95% CI: 1.341–1.561; P=0.000). A stratified analysis based on different T stages showed that the HR for death was 1.84 (P=0.000) for T1 stage patients, 1.227 (P=0.046) for T2 stage patients, and 1.157 (P=0.012) for T3 stage patients; there was no difference in survival for T4 stage patients.
Conclusions: Tumor length significantly influences the OS of esophageal cancer patients, especially in early T stage patients. Further prospective trials are needed to validate the prognostic value of tumor length among esophageal cancer patients.