Abstract:

Background and purpose: At present, the relationship between tumor length and prognosis of esophageal carcinoma patients has been a controversial topic, and there have been few studies describing the effect of tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients. The purpose of this study was to investigate the effect of the tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients. Methods: The clinicopathological characteristics and survival time of 686 nodenegative esophageal carcinoma patients, confirmed by surgical pathology specimens in the First Affiliated Hospital of Nanjing Medical University from Jan. 2008 to Dec. 2010, were retrospectively analyzed. The optimal cut-off value was determined by decision tree model. Univariate and multivariate methods were used to analyze the prognostic factors of node-negative esophageal carcinoma patients. Results: In decision tree analysis, esophageal tumor length was correlated with an increasing hazard ratio for death with a cut-off value at 3 cm. No significant differences were found in gender, onset age, lesion site and pathological type between 2 groups which were patients with tumor length ≤3 cm and tumor length >3 cm (P>0.05). The only 1 difference between 2 groups was T stage (P<0.001), and tumor length had a positive correlation with T stage (r=0.373). The 1-, 3- and 5-year survival rates of patients with tumor length ≤3 cm and tumor length >3 cm were 95.7%, 84.4%, 76.1% and 88.3%, 57.8%, 46.5% respectively, and the difference was statistically significant (P<0.001). Tumor length was significantly associated with overall survival in univariate and multivariate analyses. Conclusion: Tumor length has close relationship with T stage in node-negative esophageal carcinoma patients. Tumor length ≤3 cm could be considered as T1-2 and >3 cm as T3. Tumor length is an important prognostic factor for esophageal carcinoma patients without lymphatic metastasis.

Key words: Tumor length, Node-negative esophageal cancer, Clinicopathological characteristics, Prognosis