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Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer
Background Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes. Methods We identified patients with pT2 esophageal squamous cell carcinoma who...
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| Published in: | Journal of surgical oncology 2024-05, Vol.129 (6), p.1056-1062 |
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| container_end_page | 1062 |
| container_issue | 6 |
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| container_title | Journal of surgical oncology |
| container_volume | 129 |
| creator | Yan, Cheng‐Yi Gu, Yi‐Min Shi, Gui‐Dong Shang, Qi‐Xin Zhang, Han‐Lu Yang, Yu‐Shang Wang, Wen‐Ping Yuan, Yong Chen, Long‐Qi |
| description | Background
Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes.
Methods
We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model.
Results
A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46–6.35; p |
| doi_str_mv | 10.1002/jso.27593 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2922452131</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3043858450</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3133-fcd0b1024f3eff474ac38e540d237326e481791c8aa9d3082cd9bc0e734076273</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhkVoSLbbHvoHiqCX9uBk9OGVdSyhSRMWcsjmLLTyuNHWlryWvSH_Pkp220MgMDAw88w7w7yEfGFwxgD4-SbFM65KLY7IjIFeFBp09YHMco8XUmk4JR9T2gCA1gt5Qk5FJZgsVTkjf6-73rqRxobWiD3tpuRapD7sbPIx0Bwh1ralabTjlKgNNU3TsPO7XPOB9nb0GMZEH_34QPsVp5hi_2D_4MvMdrJdzFPOBofDJ3Lc2Dbh50Oek_vLX6uL38Xy9ur64ueycIIJUTSuhjUDLhuBTSOVtE5UWEqouVCCL1BWTGnmKmt1LaDirtZrB6iEBLXgSszJ971uP8TthGk0nU8O29YGzNcYrjmXJWd525x8e4Nu4jSEfJ0RIEVVVrKETP3YU26IKQ3YmH7wnR2eDAPz4oDJDphXBzL79aA4rTus_5P_Xp6B8z3w6Ft8el_J3Nzd7iWfAak5j4c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3043858450</pqid></control><display><type>article</type><title>Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Yan, Cheng‐Yi ; Gu, Yi‐Min ; Shi, Gui‐Dong ; Shang, Qi‐Xin ; Zhang, Han‐Lu ; Yang, Yu‐Shang ; Wang, Wen‐Ping ; Yuan, Yong ; Chen, Long‐Qi</creator><creatorcontrib>Yan, Cheng‐Yi ; Gu, Yi‐Min ; Shi, Gui‐Dong ; Shang, Qi‐Xin ; Zhang, Han‐Lu ; Yang, Yu‐Shang ; Wang, Wen‐Ping ; Yuan, Yong ; Chen, Long‐Qi</creatorcontrib><description>Background
Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes.
Methods
We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model.
Results
A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46–6.35; p < 0.001) was correlated with lymph node metastases using logistic regression. T substage (hazard ratio [HR]: 1.37, 95% CI: 1.05–1.79; p < 0.001) and N status (HR: 1.51, 95% CI: 1.05–2.17; p < 0.001) were independent risk factors in multivariate Cox regression analysis. The deep muscle invasion was associated with worse overall survival (HR: 1.52, 95% CI: 1.19–1.94; p = 0.001) than superficial, specifically in T2N0 patients (HR: 1.38, 95% CI: 1.08–1.94; p = 0.035).
Conclusions
We found that deep muscle invasion was associated with significantly worse outcomes and recommended the substaging of pT2 esophageal squamous cell carcinoma in routine pathological examination.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.27593</identifier><identifier>PMID: 38314575</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; depth of muscularis propria invasion ; Esophageal cancer ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - surgery ; esophageal squamous cell carcinoma ; Esophageal Squamous Cell Carcinoma - mortality ; Esophageal Squamous Cell Carcinoma - pathology ; Esophageal Squamous Cell Carcinoma - surgery ; Esophagectomy ; Female ; Follow-Up Studies ; Humans ; lymph node metastasis ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis ; Lymphatic system ; Male ; Metastasis ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Regression analysis ; Retrospective Studies ; Squamous cell carcinoma ; subclassification ; survival ; Survival Rate</subject><ispartof>Journal of surgical oncology, 2024-05, Vol.129 (6), p.1056-1062</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3133-fcd0b1024f3eff474ac38e540d237326e481791c8aa9d3082cd9bc0e734076273</cites><orcidid>0000-0002-7320-9740 ; 0000-0001-5100-2266</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38314575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yan, Cheng‐Yi</creatorcontrib><creatorcontrib>Gu, Yi‐Min</creatorcontrib><creatorcontrib>Shi, Gui‐Dong</creatorcontrib><creatorcontrib>Shang, Qi‐Xin</creatorcontrib><creatorcontrib>Zhang, Han‐Lu</creatorcontrib><creatorcontrib>Yang, Yu‐Shang</creatorcontrib><creatorcontrib>Wang, Wen‐Ping</creatorcontrib><creatorcontrib>Yuan, Yong</creatorcontrib><creatorcontrib>Chen, Long‐Qi</creatorcontrib><title>Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes.
Methods
We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model.
Results
A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46–6.35; p < 0.001) was correlated with lymph node metastases using logistic regression. T substage (hazard ratio [HR]: 1.37, 95% CI: 1.05–1.79; p < 0.001) and N status (HR: 1.51, 95% CI: 1.05–2.17; p < 0.001) were independent risk factors in multivariate Cox regression analysis. The deep muscle invasion was associated with worse overall survival (HR: 1.52, 95% CI: 1.19–1.94; p = 0.001) than superficial, specifically in T2N0 patients (HR: 1.38, 95% CI: 1.08–1.94; p = 0.035).
Conclusions
We found that deep muscle invasion was associated with significantly worse outcomes and recommended the substaging of pT2 esophageal squamous cell carcinoma in routine pathological examination.</description><subject>Aged</subject><subject>depth of muscularis propria invasion</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - surgery</subject><subject>esophageal squamous cell carcinoma</subject><subject>Esophageal Squamous Cell Carcinoma - mortality</subject><subject>Esophageal Squamous Cell Carcinoma - pathology</subject><subject>Esophageal Squamous Cell Carcinoma - surgery</subject><subject>Esophagectomy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>lymph node metastasis</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Squamous cell carcinoma</subject><subject>subclassification</subject><subject>survival</subject><subject>Survival Rate</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kU1r3DAQhkVoSLbbHvoHiqCX9uBk9OGVdSyhSRMWcsjmLLTyuNHWlryWvSH_Pkp220MgMDAw88w7w7yEfGFwxgD4-SbFM65KLY7IjIFeFBp09YHMco8XUmk4JR9T2gCA1gt5Qk5FJZgsVTkjf6-73rqRxobWiD3tpuRapD7sbPIx0Bwh1ralabTjlKgNNU3TsPO7XPOB9nb0GMZEH_34QPsVp5hi_2D_4MvMdrJdzFPOBofDJ3Lc2Dbh50Oek_vLX6uL38Xy9ur64ueycIIJUTSuhjUDLhuBTSOVtE5UWEqouVCCL1BWTGnmKmt1LaDirtZrB6iEBLXgSszJ971uP8TthGk0nU8O29YGzNcYrjmXJWd525x8e4Nu4jSEfJ0RIEVVVrKETP3YU26IKQ3YmH7wnR2eDAPz4oDJDphXBzL79aA4rTus_5P_Xp6B8z3w6Ft8el_J3Nzd7iWfAak5j4c</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Yan, Cheng‐Yi</creator><creator>Gu, Yi‐Min</creator><creator>Shi, Gui‐Dong</creator><creator>Shang, Qi‐Xin</creator><creator>Zhang, Han‐Lu</creator><creator>Yang, Yu‐Shang</creator><creator>Wang, Wen‐Ping</creator><creator>Yuan, Yong</creator><creator>Chen, Long‐Qi</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7320-9740</orcidid><orcidid>https://orcid.org/0000-0001-5100-2266</orcidid></search><sort><creationdate>202405</creationdate><title>Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer</title><author>Yan, Cheng‐Yi ; Gu, Yi‐Min ; Shi, Gui‐Dong ; Shang, Qi‐Xin ; Zhang, Han‐Lu ; Yang, Yu‐Shang ; Wang, Wen‐Ping ; Yuan, Yong ; Chen, Long‐Qi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3133-fcd0b1024f3eff474ac38e540d237326e481791c8aa9d3082cd9bc0e734076273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>depth of muscularis propria invasion</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - surgery</topic><topic>esophageal squamous cell carcinoma</topic><topic>Esophageal Squamous Cell Carcinoma - mortality</topic><topic>Esophageal Squamous Cell Carcinoma - pathology</topic><topic>Esophageal Squamous Cell Carcinoma - surgery</topic><topic>Esophagectomy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>lymph node metastasis</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Squamous cell carcinoma</topic><topic>subclassification</topic><topic>survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yan, Cheng‐Yi</creatorcontrib><creatorcontrib>Gu, Yi‐Min</creatorcontrib><creatorcontrib>Shi, Gui‐Dong</creatorcontrib><creatorcontrib>Shang, Qi‐Xin</creatorcontrib><creatorcontrib>Zhang, Han‐Lu</creatorcontrib><creatorcontrib>Yang, Yu‐Shang</creatorcontrib><creatorcontrib>Wang, Wen‐Ping</creatorcontrib><creatorcontrib>Yuan, Yong</creatorcontrib><creatorcontrib>Chen, Long‐Qi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yan, Cheng‐Yi</au><au>Gu, Yi‐Min</au><au>Shi, Gui‐Dong</au><au>Shang, Qi‐Xin</au><au>Zhang, Han‐Lu</au><au>Yang, Yu‐Shang</au><au>Wang, Wen‐Ping</au><au>Yuan, Yong</au><au>Chen, Long‐Qi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2024-05</date><risdate>2024</risdate><volume>129</volume><issue>6</issue><spage>1056</spage><epage>1062</epage><pages>1056-1062</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Whether T2 esophageal squamous cell carcinoma should be subclassified remains controversial. We aimed to investigate the impact of the depth of muscularis propria invasion on nodal status and survival outcomes.
Methods
We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. Clinical data were extracted from prospectively maintained databases. Tumor muscularis propria invasion was stratified into superficial or deep. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan‒Meier analysis and a Cox proportional hazard regression model.
Results
A total of 750 patients from three institutes were investigated. The depth of muscularis propria invasion (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 2.46–6.35; p < 0.001) was correlated with lymph node metastases using logistic regression. T substage (hazard ratio [HR]: 1.37, 95% CI: 1.05–1.79; p < 0.001) and N status (HR: 1.51, 95% CI: 1.05–2.17; p < 0.001) were independent risk factors in multivariate Cox regression analysis. The deep muscle invasion was associated with worse overall survival (HR: 1.52, 95% CI: 1.19–1.94; p = 0.001) than superficial, specifically in T2N0 patients (HR: 1.38, 95% CI: 1.08–1.94; p = 0.035).
Conclusions
We found that deep muscle invasion was associated with significantly worse outcomes and recommended the substaging of pT2 esophageal squamous cell carcinoma in routine pathological examination.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38314575</pmid><doi>10.1002/jso.27593</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7320-9740</orcidid><orcidid>https://orcid.org/0000-0001-5100-2266</orcidid></addata></record> |
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| subjects | Aged depth of muscularis propria invasion Esophageal cancer Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery esophageal squamous cell carcinoma Esophageal Squamous Cell Carcinoma - mortality Esophageal Squamous Cell Carcinoma - pathology Esophageal Squamous Cell Carcinoma - surgery Esophagectomy Female Follow-Up Studies Humans lymph node metastasis Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis Lymphatic system Male Metastasis Middle Aged Neoplasm Invasiveness Neoplasm Staging Prognosis Prospective Studies Regression analysis Retrospective Studies Squamous cell carcinoma subclassification survival Survival Rate |
| title | Impact of deep muscle invasion on nodal status and survival in patients with pT2 esophageal squamous cancer |
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