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Computerized tomographic prediction of extraluminal spread and prognostic implications of lesion width in esophageal carcinoma
Author(s) -
Lefor Alan T.,
Merino Maria M.,
Steinberg Seth M.,
Dwyer Andrew,
Roth Jack A.,
Flanagan Margaret,
Pass Harvey I.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19881001)62:7<1287::aid-cncr2820620707>3.0.co;2-5
Subject(s) - medicine , lesion , esophagus , radiology , esophagectomy , carcinoma , tomography , computed tomographic , esophageal cancer , nuclear medicine , computed tomography , surgery , cancer , pathology
The use of preoperative computed tomographic (CT) scans of the chest in carcinoma of the esophagus to associate preoperative staging with postoperative survival is controversial. Thirty‐two patients who underwent esophagectomy and reconstruction were examined with respect to a variety of variables available on preoperative evaluation, including lesion width on CT scan, lesion length on CT scan, and barium esophagogram. Each variable was evaluated for its ability to predict the presence of extraesophageal spread of tumor, as determined pathologically by logistic regression analysis. Lesions greater than 3.0 cm in width by CT scan were associated with a significantly higher incidence of extraesophageal spread. Tumor location, gender, histologic grade, presence of in situ lesions, vascular invasion, eosinophilia, nodal metastases, and preoperative chemotherapy had no predictive value for survival. Duration of survival was affected by the presence of esophageal spread of disease and lesion width. These results indicate that preoperative CT scanning can predict extraesophageal spread of tumor, and this is associated with overall survival.