PS02.050: TUMOR LOCATION IS AN INDEPENDENT PROGNOSTIC FACTOR OF ESOPHAGEAL ADENOCARCINOMA BASED ON THE EIGHTH EDITION OF TNM STAGING SYSTEM IN CHINESE PATIENTS

Abstract

Abstract Background Whether tumor location has any impact on the survival of esophageal adenocarcinoma patients remains controversial. In this study, we tried to investigate the prognostic value of tumor location for esophageal adenocarcinoma based on the eight edition of TNM staging system, which modified the description for positioning the esophagogastric junction (EGJ)tumor, in Chinese patients for the first time. Methods A retrospective analysis of patients who underwent esophagectomy for esophageal adenocarcinoma was conducted. Data for analysis included demographic data, comorbidity, pathologic findings, surgical approach, adjuvant therapy, and survival time. Tumor location was simply categorized into two groups (adenocarcinomas at EGJ and adenocarcinomas at other sites of esophagus). Both univariate and multivariate analyses were applied. Propensity-score matched (PSM) analysis was also conducted to eliminate the bias effects of confounding factors during comparison. Results A total of 107 patients from January 2009 to December 2015 was included for analysis. After a median follow-up time of 60.0 months, the median survival time of those patients was 41.0 months. In the univariate analysis, adenocarcinomas in the EGJ (P = 0.047), early pT stages (P = 0.030), and moderate/well differentiation (P = 0.022) were significantly correlated with better survival. In the multivariate analysis, tumor site [hazard ratio (HR) = 0.545; 95% confidence interval (CI) = 0.302–0.985], pT stage (HR = 0.295; 95% CI = 0.123–0.708), and tumor differentiation (HR = 0.458; 95% CI = 0.244–0.861) were significant independent prognostic factors for overall survival of those esophageal adenocarcinoma patients. After adjusted by PSM, adenocarcinoma at the EGJ still yielded significantly longer survival than those at other sites of esophagus (P = 0.026). Conclusion Tumor location was an independent prognostic factor for esophageal adenocarcinoma based on the eighth edition of TNM staging system in Chinese patients, which indicates that different surgical therapeutic modalities should be applied for esophageal adenocarcinoma with different tumor locations. Disclosure All authors have declared no conflicts of interest.