The prognostic impact of tumor length on pathological stage IA-IC esophageal adenocarcinoma.

Sen Yan, Xianben Liu, Wenqun Xing, Duo Jiang, Shao-Kang Feng, Andrew C Chang, Hai-Bo Sun
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Abstract

This study was completed to evaluate the relationship between tumor length and the prognosis of patients with pathological stage IA-IC esophageal adenocarcinoma (EAC). Patients were identified from the Surveillance, Epidemiology, and End Results Program database (United States, 2006-2015). X-tile software and ROC analysis were mainly used to explore the best threshold of tumor length for dividing patients into different groups, and then propensity score matching (PSM) was used to balance other variables between groups. The primary outcome assessed was overall survival (OS). A total of 762 patients were identified, and 500 patients were left after PSM. Twenty millimeters were used as the threshold of tumor length. Patients with longer tumor lengths showed worse OS (median: 93 vs. 128 months; P = 0.006). Multivariable Cox regression analysis showed that longer tumor length was an independent risk factor (hazard ratio 1.512, 95% confidence interval, 1.158-1.974, P = 0.002). Tumor length has an impact on patients with pathological stage IA-IC EAC who undergo surgery alone. The prognostic value of the pathological stage group may be improved after combining it with tumor length and age.

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肿瘤长度对病理分期为 IA-IC 期食管腺癌的预后影响。
本研究旨在评估病理分期为 IA-IC 期食管腺癌(EAC)患者的肿瘤长度与预后之间的关系。患者从监测、流行病学和最终结果计划数据库(美国,2006-2015 年)中识别。主要使用X-tile软件和ROC分析来探索将患者分为不同组的最佳肿瘤长度阈值,然后使用倾向评分匹配(PSM)来平衡组间的其他变量。评估的主要结果是总生存期(OS)。共确定了 762 名患者,经过倾向评分匹配后,剩下 500 名患者。肿瘤长度的临界值为20毫米。肿瘤长度较长的患者的 OS 较差(中位:93 个月对 128 个月;P = 0.006)。多变量考克斯回归分析显示,肿瘤长度较长是一个独立的风险因素(危险比 1.512,95% 置信区间 1.158-1.974,P = 0.002)。肿瘤长度对单纯接受手术治疗的病理分期为IA-IC期的EAC患者有影响。将病理分期组与肿瘤长度和年龄相结合,可提高其预后价值。
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