Survival prognostic factors in esophagectomized patients due to squamous cell carcinoma of the esophagus

ABSTRACT

Introduction: Among esophageal tumors, squamous cell carcinoma is the most common and with a poor outcome. Itsprognostic factors are controversial and the long-term results dismal. It is essential, though, to have a detailed knowledge of the characteristics of this group of patients and its prognostic factors. Objective: To evaluate clinical, surgical and pathologicalparameters of patients with esophageal squamous cell carcinoma submitted to esophagectomy and identify prognostic factors of overall survival. Secondary Objectives: To evaluate surgery safety and mortality. Methods: A retrospective cohort study was done with 47 patients submitted to esophagectomy due to squamous cell esophageal cancer admitted in the Abdominal Surgery Department of A.C.Camargo Cancer Hospital, Sao Paulo. The period considered was October 1998 - December 2004. Results: Overall 2 and 5-year survival rates were 41.1% and 18.1%, respectively. There were statistically significant differences in 5-year overall survival probability for the treatment intention (p=0.0017), residual disease (R) (p=0.0111),lymphatic invasion (p=0.0180), T (p=0.0077), M (p=0.0166), clinical stage (p=0.0020). The independent prognostic factors were lymphatic invasion (HR=2.41) and pathologic “T“ (HR=2.19). Conclusions: Surgical treatment of esophageal cancer is a safe procedure, with low hospital mortality (2.1 %). The most important factors associated to 5-year overall survivalis treatment intention, residual disease (R), lymphatic invasion, and T M clinical stage. Independent prognostic factors are lymphatic invasion and pathologic T.