Abstract:Objective To investigate the clinical staging of non-surgically treated esophageal cancer based on endoscopic ultrasonography (EUS) and computed tomography (CT) and its prognostic value. Methods A total of 290 patients with esophageal squamous cell carcinoma who received non-surgical treatment in our hospital from November 2003 to March 2012 were retrospectively reviewed. The clinical stage of each patient was evaluated based on EUS and CT according to the 2002 UICC TNM staging system. The survival rates and prognostic factors for patients of different stages were analyzed. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis;the multivariate analysis was performed using the Cox model. Results EUS could be completely performed in 178(61.4%) of all patients, and their EUS T and N stages were determined. There were no significant differences in overall survival (OS) between patients with EUS T1-T4 diseases (P=0.247);there were significant differences in OS and progression-free survival (PFS) between individuals of different EUS T stages among patients with EUS N0 disease (P=0.000;P=0.006). OS and PFS also showed significant differences between patients with N0 and N1 diseases (P=0.012;P=0.016). EUS could not be completely performed in 112 patients, who had poorer OS and PFS than other patients (P=0.001;P=0.003). CT T and N stages also affected OS and PFS (OS P=0.004, PFS P=0.030;OS P=0.024, PFS P=0.020). The 1-, 3-, and 5-year sample sizes were 290, 174, and 73, respectively. The 1-, 3-, and 5-year OS rates for all patients were 61.7%, 27.8%, and 19.8%, respectively. OS and PFS varied significantly between patients of different 2002 UICC clinical stages (P=0.000 and 0.000). The multivariate analysis showed that sex, age and clinical stage were independent prognostic factors (P=0.004, 0.020, and 0.002).Conclusions The clinical staging based on EUS and CT can predict the survival in esophageal cancer DOI:10.3760/cma.j.issn.1004-4221.2014.02.010 基金项目:首都特色临床应用研究(Z121107001012004) 作者单位:100021 北京协和医学院,中国医学科学院肿瘤医院放疗科 通信作者:肖泽芬,Email:xiaozefen@sina.compatients treated with non-surgical method. EUS is recommended as a basic means for pretreatment staging of esophageal cancer in China.
Liu Xiao,Yu Shufei,Xiao Zefen et al. Clinical staging of non-surgically treated esophageal cancer based on EUS and CT and its prognostic value[J]. Chinese Journal of Radiation Oncology, 2014, 23(2): 117-122.
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