LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY
ABSTRACT Background: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. Aim: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2021-01-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000300313&tlng=en |
| _version_ | 1828131843055026176 |
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| author | Manuel FIGUEROA-GIRALT Catalina VALENZUELA Andrés TORREALBA Attila CSENDES Italo BRAGHETTO Enrique LANZARINI Maher MUSLEH Owen KORN Hector VALLADARES Solange CORTÉS |
| author_facet | Manuel FIGUEROA-GIRALT Catalina VALENZUELA Andrés TORREALBA Attila CSENDES Italo BRAGHETTO Enrique LANZARINI Maher MUSLEH Owen KORN Hector VALLADARES Solange CORTÉS |
| author_sort | Manuel FIGUEROA-GIRALT |
| collection | DOAJ |
| description | ABSTRACT Background: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. Aim: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal index (N+/T). Method: Prospective study of the Universidad de Chile Clinical Hospital, between January 2004 and December 2013. Included all esophageal cancer surgeries with curative intent and cervical anastomosis. Exclusion criteria included: stage 4 cancers, R1 resections, palliative procedures and emergency surgeries. Results: Fifty-eight patients were included, 62.1% were men, the average age was 63.3 years. A total of 48.3% were squamous, 88% were advanced cancers, the average lymph node harvest was 17.1. Post-operative surgical morbidity was 75%, with a 17.2% of reoperations and 3.4% of mortality. The average overall survival was 41.3 months, the 3-year survival was 31%. Multivariate analysis of the prognostic factors showed that significant variables were anterior mediastinal ascent (p=0.01, OR: 6.7 [1.43-31.6]), anastomotic fistula (p=0.03, OR: 0.21 [0.05-0.87]), N classification (p=0.02, OR: 3.8 [1.16-12.73]), TNM stage (p=0.04, OR: 2.8 [1.01-9.26]), and lymphoparietal index (p=0.04, RR: 3.9 [1.01-15.17]. The ROC curves of lymphoparietal index, N classification and TNM stage have areas under the curve of 0.71, 0.63 and 0.64 respectively, with significant statistical difference (p=0.01). Conclusion: The independent prognostic factors of long-term survival in esophageal cancer are anterior mediastinal ascent, anastomotic fistula, N classification, TNM stage and lymphoparietal index. In esophageal cancer the new lymphoparietal index is stronger than TNM stage in long-term survival prognosis. |
| first_indexed | 2024-04-11T16:54:10Z |
| format | Article |
| id | doaj.art-5ab04d1ed3f14c50ac97a779530dbb2e |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-04-11T16:54:10Z |
| publishDate | 2021-01-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-5ab04d1ed3f14c50ac97a779530dbb2e2022-12-22T04:13:20ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202021-01-0133310.1590/0102-672020200003e1547LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRYManuel FIGUEROA-GIRALThttps://orcid.org/0000-0003-4907-5727Catalina VALENZUELAhttps://orcid.org/0000-0002-7283-4835Andrés TORREALBAhttps://orcid.org/0000-0003-3084-1858Attila CSENDEShttps://orcid.org/0000-0002-7524-8057Italo BRAGHETTOhttps://orcid.org/0000-0003-2024-3029Enrique LANZARINIhttps://orcid.org/0000-0003-2817-3889Maher MUSLEHhttps://orcid.org/0000-0002-4717-0336Owen KORNhttps://orcid.org/0000-0001-7840-2534Hector VALLADAREShttps://orcid.org/0000-0001-9477-176XSolange CORTÉShttps://orcid.org/0000-0002-6740-104XABSTRACT Background: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. Aim: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal index (N+/T). Method: Prospective study of the Universidad de Chile Clinical Hospital, between January 2004 and December 2013. Included all esophageal cancer surgeries with curative intent and cervical anastomosis. Exclusion criteria included: stage 4 cancers, R1 resections, palliative procedures and emergency surgeries. Results: Fifty-eight patients were included, 62.1% were men, the average age was 63.3 years. A total of 48.3% were squamous, 88% were advanced cancers, the average lymph node harvest was 17.1. Post-operative surgical morbidity was 75%, with a 17.2% of reoperations and 3.4% of mortality. The average overall survival was 41.3 months, the 3-year survival was 31%. Multivariate analysis of the prognostic factors showed that significant variables were anterior mediastinal ascent (p=0.01, OR: 6.7 [1.43-31.6]), anastomotic fistula (p=0.03, OR: 0.21 [0.05-0.87]), N classification (p=0.02, OR: 3.8 [1.16-12.73]), TNM stage (p=0.04, OR: 2.8 [1.01-9.26]), and lymphoparietal index (p=0.04, RR: 3.9 [1.01-15.17]. The ROC curves of lymphoparietal index, N classification and TNM stage have areas under the curve of 0.71, 0.63 and 0.64 respectively, with significant statistical difference (p=0.01). Conclusion: The independent prognostic factors of long-term survival in esophageal cancer are anterior mediastinal ascent, anastomotic fistula, N classification, TNM stage and lymphoparietal index. In esophageal cancer the new lymphoparietal index is stronger than TNM stage in long-term survival prognosis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000300313&tlng=enEsophageal neoplasmsSurvivalPrognosis |
| spellingShingle | Manuel FIGUEROA-GIRALT Catalina VALENZUELA Andrés TORREALBA Attila CSENDES Italo BRAGHETTO Enrique LANZARINI Maher MUSLEH Owen KORN Hector VALLADARES Solange CORTÉS LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY ABCD: Arquivos Brasileiros de Cirurgia Digestiva Esophageal neoplasms Survival Prognosis |
| title | LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY |
| title_full | LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY |
| title_fullStr | LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY |
| title_full_unstemmed | LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY |
| title_short | LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY |
| title_sort | lymphoparietal index in esophageal cancer is stronger than tnm staging in long term survival prognosis in a latin american country |
| topic | Esophageal neoplasms Survival Prognosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000300313&tlng=en |
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