Tumour length as an independent prognostic factor in resectable oesophageal carcinoma.

Πολύ πρόσφατη μελέτη μας σε διεθνές περιοδικό σχετικά με την αξία του μήκους του όγκου ως προγνωστικού παράγοντα στον οισοφαγικό καρκίνο. Η μελέτη κατέδειξε ότι το ιστολογικό μήκος μπορεί να θεωρηθεί ως ανεξάρτητος προγνωστικός παράγοντας στην τοπική υποτροπή, τις μεταστάσεις, την εξέλιξη της νόσου και την επιβίωση του ασθενή χωρίς εξέλιξη της νόσου.

Vadhwana B, Zosimas D, Lykoudis PM, Phen HM, Martinou M, Khoo D.

Ann R Coll Surg Engl. 2019 Nov 22:1-6. doi: 10.1308/rcsann.2019.0147. [Epub ahead of print]


Introduction: Oesophageal longitudinal tumour length has been investigated as a prognostic indicator for disease recurrence and overall survival in resectable oesophageal carcinoma. However, there is conflicting evidence regarding its use in clinical practice. This study aims to assess the prognostic significance of histological tumour length in potentially curative oesophageal resections for cancer.

Materials and Methods: Patients with locally advanced oesophageal carcinoma (squamous or adenocarcinoma) were identified in a single centre between July 2000 and December 2016. Patient demographics, tumour characteristics and survival outcomes were assimilated. Unifactorial and multifactorial analysis was performed to assess tumour length correlation with oncological outcomes.

Results: A total of 281 patients were included; 226 (80.4%) male and 55 (19.6%) female, with a median age of 66 years; 39 patients (13.9%) developed local recurrence and 104 (37%) distant metastases. Disease progression rate was 44.8% with a median progression-free survival of 21 months and median overall survival of 30 months. Median tumour length was 3 cm (interquartile range 2-4.5 cm). Multivariate analysis demonstrated longer tumours to be significantly associated with a higher rate of local recurrence (p=0.028), metastases (p=0.016), disease progression (p=0.001) and shorter progression-free survival (p=0.001).

Discussion: This study demonstrates histological tumour length as an independent prognostic factor for local recurrence, metastases, disease progression and progression-free survival. Further larger multicentre studies are required to define the role of longitudinal tumour length as a marker to identify patients who are at higher risk of poor oncological outcomes following surgery.

PMID: 31755735, DOI: 10.1308/rcsann.2019.0147




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