Survival and prognostic evaluation of superficial esophageal cancer after surgery

Abstract

To calculate the survival rate of patients with superficial esophageal squamous carcinoma who received esophageal resection and to explore factors that affect prognosis. There were 285 patients with pTis-T1 esophageal carcinoma who underwent esophagectomy during 2007-2011. Their cumulative survival rates were calculated using life tables. Nine factors that may have impact on postoperative survival of superficial esophageal carcinoma were selected. The Kaplan-Meier method and COX's regression model were used to select prognostic factors, estimate prognostic index, and establish risk stratification. The 1-, 3- and 5-year overall survival rates of superficial esophageal carcinoma patients were 97%, 86%, and 82%, respectively. Tumor length, stenosis, depth of invasion, differentiation degree, lymph node metastasis, and vascular tumor thrombus were associated with prognosis according to univariate analysis. Depth of invasion (OR=2.065, P=0.029), lymph node metastasis (OR=2.049, P=0.041), differentiation degree (OR=3.828, P=0.000), stenosis(OR=2.129, P=0.048), and vascular tumor thrombus (OR=4.222, P=0.004) were independent prognostic factors in multivariate analysis. A prognostic models was thus established and all the patients were divided into low-risk, moderate-risk and high-risk group, with the 3-year survival rates being 95%, 84%, and 51%, and 5-year survival rates being 93%, 79%, and 44%, respectively. Patients with superficial esophageal cancer have relatively favorable prognosis. Depth of invasion, differentiation degree, stenosis, lymph node metastasis, and vascular tumor thrombus may be independent factors of poor prognosis. Survival rate of moderate- and high-risk patients is yet to be improved.