Top

World Journal of Surgery

Published in:

01-01-2020 | Metastasis | Original Scientific Report

Depth of Invasion into the Circular and Longitudinal Muscle Layers in T2 Esophageal Squamous Cell Carcinoma Does Not Affect Prognosis or Lymph Node Metastasis: A Multicenter Retrospective Study

Authors: Dong Tian, Heng Huang, Yu-Shang Yang, Kai-Yuan Jiang, Xi He, Xiao-Guang Guo, Long-Qi Chen

Published in: World Journal of Surgery | Issue 1/2020

Abstract

Background

Although a greater depth of tumor invasion is correlated with a poorer prognosis in esophageal squamous cell carcinoma (ESCC), it remains controversial whether T2 ESCC should be subclassified by circular and longitudinal muscle invasion. We conducted a multicenter retrospective study to evaluate the relationship between the depth of invasion and long-term outcome and to identify the clinical significance of subclassifying T2 ESCC.

Methods

Patients with T2 ESCC who underwent esophagectomy at two different institutes between January 2009 and December 2017 were analyzed retrospectively. ESCC with circular and longitudinal muscle invasion was defined as T2 circular and T2 longitudinal ESCC, respectively. Survival outcomes and risk factors for lymph node metastasis (LNM) were evaluated by univariate and multivariate analyses. In addition, data from stage T1b ESCC cases during the same period were retrieved for use as a comparison cohort to evaluate the prognostic significance of the T2 substage.

Results

A total of 536 T2 ESCC patients were eligible, and 192 (36%) patients developed LNM. No significant difference was found in general characteristics between the T2 circular and T2 longitudinal ESCC groups (n = 219 and n = 317, P > 0.05), except for tumor location (P = 0.02). The T2 substage was not significantly correlated with survival on univariate or multivariate analysis (P = 0.30 and P = 0.34, respectively). Multivariate analysis also indicated that the T2 substage was not an independent risk factor for LNM (P = 0.15). When patients with stage T1b ESCC were considered, their survival time was significantly different from that of patients with T2 circular and T2 longitudinal disease (P = 0.01).

Conclusions

The depth of tumor invasion into the circular and longitudinal muscle layers in T2 ESCC does not affect the prognosis or risk of LNM.

Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRef

Tian D, Mo SJ, Han LK et al (2018) Investigation of dietary factors and esophageal cancer knowledge: comparison of rural residents in high- and low-incidence areas. Sci Rep 8:4914CrossRef

Zhang JQ, Hooker CM, Brock MV, et al (2012) Neoadjuvant chemoradiation therapy is beneficial for clinical stage T2 N0 esophageal cancer patients due to inaccurate preoperative staging. Ann Thorac Surg 93:429–435CrossRef

Dolan JP, Kaur T, Diggs BS et al (2016) Significant understaging is seen in clinically staged T2N0 esophageal cancer patients undergoing esophagectomy. Dis Esophagus 29:320–325CrossRef

Crabtree TD, Kosinski AS, Puri V et al (2013) Evaluation of the reliability of clinical staging of T2 N0 esophageal cancer: a review of the society of thoracic surgeons database. Ann Thorac Surg 96:382–390CrossRef

Rice TW, Mason DP, Murthy SC et al (2007) T2N0M0 esophageal cancer. J Thorac Cardiovasc Surg 133:317–324CrossRef

Amin MB, Greene FL, Edge SB, et al (2017) The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin 67:93–99CrossRef

Guo W, Xiao HL, Ma Z et al (2014) Should stage T2 esophageal squamous cell carcinoma be subclassified? Ann Surg Oncol 21:2540–2545CrossRef

Duan J, Deng T, Ying G et al (2017) Prognostic significance of the T2 substage in patients with esophageal squamous cell carcinoma. Dis Esophagus 30:1–7CrossRef

10.

Seder CW, Mahon B, Hennon M et al (2018) Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma. Anticancer Res 38:2195–2200PubMed

11.

Rice TW, Zuccaro G Jr, Adelstein DJ et al (1998) Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status. Ann Thorac Surg 65:787–792CrossRef

12.

Nentwich MF, von Loga K, Reeh M et al (2014) Depth of submucosal tumor infiltration and its relevance in lymphatic metastasis formation for T1b squamous cell and adenocarcinomas of the esophagus. J Gastrointest Surg Off J Soc Surg Aliment Tract 18:242–249CrossRef

13.

Endo M, Yoshino K, Kawano T et al (2000) Clinicopathologic analysis of lymph node metastasis in surgically resected superficial cancer of the thoracic esophagus. Dis Esophagus 13:125–129CrossRef

14.

Wagner TD, Khushalani N, Yang GY (2010) Clinical T2N0M0 carcinoma of thoracic esophagus. J Thorac Dis 2:36–42PubMedPubMedCentral

15.

Chen J, Liu S, Pan J et al (2009) The pattern and prevalence of lymphatic spread in thoracic oesophageal squamous cell carcinoma. Eur J Cardio Thorac Surg Off J Eur Assoc Cardio Thorac Surg 36:480–486CrossRef

16.

Schwarz RE, Smith DD (2007) Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg Off J Soc Surg Aliment Tract 11:1384–1393CrossRef

17.

Sancheti M, Fernandez F (2012) Management of T2 esophageal cancer. Surg Clin N Am 92:1169–1178CrossRef

18.

Martin JT, Worni M, Zwischenberger JB et al (2013) The role of radiation therapy in resected T2 N0 esophageal cancer: a population-based analysis. Ann Thorac Surg 95:453–458CrossRef

19.

Hollis AC, Quinn LM, Hodson J et al (2017) Prognostic significance of tumor length in patients receiving esophagectomy for esophageal cancer. J Surg Oncol 116:1114–1122CrossRef

Title: Depth of Invasion into the Circular and Longitudinal Muscle Layers in T2 Esophageal Squamous Cell Carcinoma Does Not Affect Prognosis or Lymph Node Metastasis: A Multicenter Retrospective Study
Authors: Dong Tian
Heng Huang
Yu-Shang Yang
Kai-Yuan Jiang
Xi He
Xiao-Guang Guo
Long-Qi Chen
Publication date: 01-01-2020
Publisher: Springer International Publishing
Keywords: Metastasis
Esophageal Cancer
Esophageal Cancer
Published in: World Journal of Surgery / Issue 1/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05194-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Depth of Invasion into the Circular and Longitudinal Muscle Layers in T2 Esophageal Squamous Cell Carcinoma Does Not Affect Prognosis or Lymph Node Metastasis: A Multicenter Retrospective Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

New Concept Air Conditioning System for the Operating Room to Minimize Patient Cooling and Surgeon Heating: A Historical Control Cohort Study

Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Association of Genetic Risk of Obesity with Postoperative Complications Using Mendelian Randomization

Curative Surgery Improves Survival for Colorectal Cancer in Rural Kenya

The ALBI Grade is a Good Predictive Model for Very Late Recurrence in Patients with Hepatocellular Carcinoma Undergoing Primary Resection

Early Red Flags Associated with Delayed Discharge in Patients Undergoing Gastrectomy: Analysis of Perioperative Variables and ERAS Protocol Items