Commentary: Risk stratification for superficial esophageal adenocarcinoma: Reducing risk in a risky business!
| Autor: | Siva Raja, Saurav Adhikari |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology medicine.medical_specialty Esophageal Neoplasms business.industry MEDLINE Esophageal adenocarcinoma Adenocarcinoma Risk Assessment Article Text mining Internal medicine Risk stratification medicine Humans Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | J Thorac Cardiovasc Surg |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2020.11.130 |
| Popis: | OBJECTIVE: As endoscopic approaches become more widely used to treat early-stage esophageal cancer, reliably identifying patients with less-aggressive tumors is paramount. We therefore sought to identify risk factors for recurrence in patients with completely resected T1 esophageal adenocarcinoma. METHODS: We retrospectively analyzed a single-institutional database for all patients with completely resected pathologic T1 esophageal adenocarcinoma (1996–2016). Risk factors for recurrence were identified using competing-risk regression methods. Risk stratification was performed on the basis of known preoperative clinicopathologic factors; this model’s discriminative power for overall survival was evaluated using a Cox proportional hazards model. RESULTS: Of 243 patients, 32 experienced recurrence. At a median follow-up among survivors of 4 years (range, 0.05–19), the 5-year cumulative incidence of recurrence was 15%, and median time to recurrence was 2 years (range, 0.26–6.13). On univariable analysis, submucosal invasion, N1 disease, poor differentiation, tumor length, lymphovascular invasion, and multicentricity were significantly associated with recurrence. On multivariable analysis, N1 disease (hazard ratio, 2.93; 95% CI, 1.17–7.34; P = 0.022) and tumor length (hazard ratio, 1.44; 95% CI, 1.12–1.86; P = 0.004) were independently associated with recurrence. Risk stratification showed that patients without lymphovascular invasion and a with median tumor length of 0.8 cm (range, 0.10–1.70) had a |
| Databáze: | OpenAIRE |
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