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Lymphatic vessel invasion is an independent prognostic factor in patients with a primary resected tumor with esophageal squamous cell carcinoma
Author(s) -
Brücher Björn L. D. M.,
Stein Hubert J.,
Werner Martin,
Siewert Jörg R.
Publication year - 2001
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(20011015)92:8<2228::aid-cncr1567>3.0.co;2-4
Subject(s) - medicine , lymphovascular invasion , univariate analysis , carcinoma , esophageal cancer , gastroenterology , multivariate analysis , survival analysis , cancer , metastasis
BACKGROUND Little data exist about the prognostic role of a lymphatic vessel invasion (LVI) in patients with esophageal carcinoma. The objective of this study was to clarify the presence and prognostic impact of LVI in a large group of patients resected for esophageal squamous cell carcinoma (SCC) at one surgical center. METHODS Three hundred sixty‐six patients, who had a primary resection for SCC, were analyzed by univariate and multivariate analysis. Follow‐up was complete for 93.7% patients with a median follow‐up of 8.3 years. RESULTS The total rate of LVI was 39.1% ( n = 143). Univariate analysis revealed a significant relation between LVI and different T classifications ( P = 0.001), N classifications ( P < 0.0001), M classifications ( P < 0.0001), International Union Against Cancer (UICC) stages ( P < 0.0001), and residual tumor ( P < 0.0001). Multivariate analysis of the patients with R0‐resected tumors proved LVI as an independent prognostic factor. The 2‐, 5‐ and 10‐year survival rates in patients with LVI were 28.5%, 11.1%, and 9.2% compared with 63.4%, 46.6%, and 27%, respectively, without LVI ( P < 0.0001). Patients with LVI had a median survival time of 11.4 months compared with 28.6 months without LVI ( P < 0.0001). Patients with R0‐resected tumors without LVI had a median survival time of 54.1 months compared with 12.1 months in patients with LVI ( P < 0.0001) and compared with 11.3 months in patients with R1‐resected tumors P < 0.0001). CONCLUSIONS These data clearly show that LVI is an independent prognostic factor in patients with SCC and confirm the importance of a systematic pathohistologic workup. The prognosis of patients with R0‐resected tumors with LVI is equal to patients with an incomplete tumor resection. This supports the inclusion of LVI in the UICC classification system for esophageal carcinoma. Cancer 2001;92:2228–33. © 2001 American Cancer Society.