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What are the independent prognostic factors in patients undergoing esophagectomy for esophageal cancer? TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2022; 30:83-91. [PMID: 35444852 PMCID: PMC8990145 DOI: 10.5606/tgkdc.dergisi.2022.20969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022]
Abstract
Background
This study aims to investigate the prognostic factors affecting survival in patients undergoing surgical treatment for esophageal cancer.
Methods
A total of 50 patients (33 males, 17 females; mean age: 57.8±11.8 years; range, 28 to 80 years) who underwent esophagectomy for esophageal cancer in our clinic between January 2008 and March 2018 were retrospectively analyzed. Prognostic factors affecting survival were investigated. Data including age, sex, tumor size, histological and macroscopic type, tumor stage, T and N categories, the total number of resected lymph nodes and metastatic lymph node ratio, differentiation degree, vascular and perineural invasion, proximal surgical margin distance, adjuvant therapy, and the presence of postoperative complications were recorded.
Results
The patients after radical surgery with a tumor size of <3 cm, macroscopic type non-ulcerative-infiltrative squamous cell carcinoma pathology, Stage 1 disease, pT1-2, pN0, well-differentiated groups, no perineural invasion, a metastatic lymph node ratio of <0.2, proximal surgery margin length of 5 to 10 cm, and no postoperative complications had higher five-year survival rates. However, when the effects of these factors on overall survival were examined independently, none of them had a statistically significant effect (p>0.05). The main factors affecting the prognosis were Stage ≥2 disease, postoperative complications, and proximal surgical margin less than 5 cm.
Conclusion
Our study results suggest that Stage 1 disease, a proximal surgical margin length of more than 5 cm, and the absence of complications are associated with longer survival times and these patients are greatly benefited from surgical treatment.
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Li XM, Song X, Zhao XK, Hu SJ, Cheng R, Lv S, Du DF, Zhang XY, Lu JL, Ku JW, Zhang DY, Zhang Y, Fan ZM, Wang LD. The alterations of cytokeratin and vimentin protein expressions in primary esophageal spindle cell carcinoma. BMC Cancer 2018; 18:356. [PMID: 29609569 PMCID: PMC5880062 DOI: 10.1186/s12885-018-4301-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
Background The accumulated evidence has indicated the diagnostic role of cytokeratin (CK) and vimentin protein immunoassay in primary esophageal spindle cell carcinoma (PESC), which is a rare malignant tumor with epithelial and spindle components. However, it is largely unknown for the expression of CK and vimentin in pathological changes and prognosis of PESC. Methods Eighty-two PESC patients were identified from the esophageal and gastric cardia cancer database established by Henan Key Laboratory for Esophageal Cancer Research of Zhengzhou University. We retrospectively evaluated CK and vimentin protein expressions in PESC. Clinicopathological features were examined by means of univariate and multivariate survival analyses. Furthermore, the co-expression value of cytokeratin and vimentin was analyzed by receiver operating characteristic (ROC) curve. Results The positive pan-cytokeratins AE1/AE3 (AE1/AE3 for short) staining was chiefly observed in cytoplasm of epithelial component tumor cells, with a positive detection rate of 85.4% (70/82). Interestingly, 19 cases showed AE1/AE3 positive staining both in epithelial and spindle components (23.2%). However, AE1/AE3 expression was not observed with any significant association with age, gender, tumor location, gross appearance, lymph node metastasis and TNM stage. Furthermore, AE1/AE3 protein expression does not show any effect on survival. Similar results were observed for vimentin immunoassay. However, in comparison with a single protein, the predictive power of AE1/AE3 and vimentin proteins signature was increased apparently than with single signature [0.75 (95% CI = 0.68–0.82) with single protein v.s. 0.89 (95% CI = 0.85–0.94) with AE1/AE3 and vimentin proteins]. The 1-, 3-, 5- and 7-year survival rates for PESC patients in this study were 79.3%, 46.3%, 28.0% and 15.9%, respectively. Multivariate analysis demonstrated age and TNM stage were independent prognostic factors for overall survival (P = 0.036 and 0.003, respectively). It is noteworthy that only 17.1% patients had a PESC accurate diagnosis by biopsy pathology before surgery (14/82). 72.4% PESC patients with biopsy pathology before surgery had been diagnosed as squamous cell carcinoma. Conclusion The present study demonstrates that cytokeratin and vimentin protein immunoassay is a useful biomarker for PESC accurate diagnosis, but not prognosis. The co-expression of cytokeratin and vimentin in both epithelial and spindle components suggest the possibility of single clone origination for PESC.
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Affiliation(s)
- Xin Min Li
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xin Song
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xue Ke Zhao
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Shou Jia Hu
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Rang Cheng
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Shuang Lv
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Dan Feng Du
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology of Basic Medical College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiang Yang Zhang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Jian Liang Lu
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Jian Wei Ku
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Gastroenterology, the Second Affiliated Hospital of Nanyang Medical College, Nanyang, 473061, Henan, China
| | - Dong Yun Zhang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.,Department of Pathology of Nanyang Medical College, Nanyang, 473061, Henan, China
| | - Yao Zhang
- Department of Pathology, Women & Infants Hospital of Zhengzhou, Zhengzhou, 450012, Henan, China
| | - Zong Min Fan
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Li Dong Wang
- Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, 40 Daxue Road, Zhengzhou, Henan, 450052, People's Republic of China.
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