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. 2019 Oct;8(14):6326-6334.
doi: 10.1002/cam4.2532. Epub 2019 Sep 4.

Prognostic value of tumor length and diameter for esophageal squamous cell cancer patients treated with definitive (chemo)radiotherapy: Potential indicators for nonsurgical T staging

Hongyao Xu  1 , Shengxi Wu  1 , Hesan Luo  1 , Chuyun Chen  1 , Lianxing Lin  1 , Hecheng Huang  1 , Renliang Xue  1
Affiliations

Prognostic value of tumor length and diameter for esophageal squamous cell cancer patients treated with definitive (chemo)radiotherapy: Potential indicators for nonsurgical T staging

Hongyao Xu et al. Cancer Med. 2019 Oct.

Abstract

Purpose: The aim of this work was to evaluate the prognostic value of tumor length and diameter for patients with esophageal squamous cell cancer (ESCC) treated with definitive (chemo)radiotherapy to identify potential indicators for separate nonsurgical T staging, which are needed in clinical practice.

Materials and methods: A total of 682 patients with ESCC who underwent definitive (chemo)radiotherapy between 2009 and 2015 were reviewed. Esophageal tumor length and diameter were determined by barium esophagography and computed tomography before treatment. Univariate and multivariate analyses were used to assess the impact of tumor length and diameter on long-term overall survival (OS) and progression-free survival (PFS). Propensity score matching (PSM) analysis was also used to control intergroup heterogeneity.

Results: The median OS and PFS were 22.2 months and 15.4 months, respectively, in the tumor length ≤ 6 cm group, which were significantly longer than those in the tumor length > 6 cm group (13.4 and 8.5 months, respectively). The median OS and PFS were 23.3 months and 15.9 months, respectively, in the tumor diameter ≤ 3.5 cm group, which were also significantly longer than those in the tumor diameter > 3.5 cm group (13.3 and 8.8 months, respectively). Similar results were found after PSM. Univariate and multivariate analyses showed that tumor length and diameter were both independent predictors of long-term survival.

Conclusion: Tumor length and diameter are both independent prognostic factors for ESCC patients treated with definitive (chemo)radiotherapy. These two imaging parameters have the potential for development and use in nonsurgical T staging.

Keywords: esophageal squamous cell cancer; neoplasm staging; radiotherapy; tumor diameter; tumor length.

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Conflict of interest statement

Conflict of interest relevant to this article was not reported.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves of OS for patients grouped by length before (A) and after (B) propensity score matching. —, length ≤ 6 cm; ‐‐‐, length > 6 cm
Figure 2
Figure 2
Kaplan‐Meier survival curves of PFS for patients grouped by length before (A) and after (B) propensity score matching. —, length ≤ 6 cm; ‐‐‐, length > 6 cm
Figure 3
Figure 3
Kaplan‐Meier survival curves of OS for patients grouped by diameter before (A) and after (B) propensity score matching. —, diameter ≤ 3.5 cm; ‐‐‐, diameter > 3.5 cm
Figure 4
Figure 4
Kaplan‐Meier survival curves of PFS for patients grouped by diameter before (A) and after (B) propensity score matching. —, diameter ≤ 3.5 cm; ‐‐‐, diameter > 3.5 cm
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