This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Pathological determinants of survival in node‐negative oesophageal cancer. BJS 2004; 91: 1586-1591.
Published: 25th October 2004
Authors: O. A. Khan, C. Alexiou, I. Soomro, J. P. Duffy, W. E. Morgan, F. D. Beggs et al.
Background
Many studies have analysed prognostic factors following oesophagectomy, but few have examined survival determinants in node‐negative (N0) oesophageal cancer. The prognostic significance of a number of histological variables following surgical resection of N0 oesophageal cancer was studied.
Method
The case notes of 219 patients undergoing potentially curative oesophagectomy for N0 squamous cell carcinoma or adenocarcinoma of the oesophagus were reviewed. Details of the patient's sex, age at operation, histological type, longitudinal tumour length, tumour (T) stage, circumferential resection margin involvement, tumour grade, presence of vascular invasion, perineural invasion, Barrett's metaplasia, and survival were noted. Univariate and multivariate analyses were performed to identify prognostic factors.
Results
Univariate analysis revealed three factors that correlated with poor prognosis: T stage (P = 0·024), adenocarcinoma (P = 0·033) and degree of differentiation (P = 0·001). Multivariate analysis revealed that all three were significant independent adverse prognostic indicators.
Conclusion
Surgical resection of node‐negative oesophageal cancer is associated with diverse long‐term outcomes. This diversity of outcome is not reflected in the tumour node metastasis (TNM)‐based staging system. The utility of the TNM system in predicting prognosis after surgical resection is open to question. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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