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Tumor Volume Index as a Prognostic Factor in Patients after Curative Esophageal Cancer Resection

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The tumor, node, metastasis classification system for staging esophageal cancer does not include tumor volume although it may be an important prognostic factor. We evaluated the prognostic value of tumor volume in esophageal cancer.

Methods

We performed a retrospective study in patients with histologically confirmed primary esophageal cancer who underwent curative esophagectomy at our facility between April 1992 and December 2013. The Tumor Depth Parameter (TDP) was defined as mucosa = 1, submucosa = 2, muscularis propria = 3, adventitia = 4, and invasion into adjacent organs = 5. The pathological Tumor Volume Index (TVI) was defined as the major axis × the minor axis × TDP. The appropriate tumor diameter and TVI cutoff values were determined by the Youden index obtained from the receiver operating characteristic curve. Prognostic factors for overall survival were evaluated by univariate analysis and Cox proportional hazards regression models.

Results

We enrolled 302 patients. In the univariate analysis, patient age and sex, thoracoscopic surgery, tumor depth of invasion and diameter, lymph node metastasis, and the TVI were significantly associated with overall survival. In our multivariate analysis, patient age and sex, thoracoscopic surgery, lymph node metastasis, and the TVI were independently associated with overall survival.

Conclusions

The pathological TVI was an independent prognostic factor in patients with esophageal carcinoma and could be included in the staging system of esophageal cancer.

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Disclosure

Hiroshi Miyamoto has no disclosures to declare.

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan

    Hiroshi Miyamoto MD, PhD, Chikara Kunisaki MD, PhD, Sho Sato MD, PhD, Yusaku Tanaka MD, Kei Sato MD & Norio Yukawa MD, PhD

  2. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Takashi Kosaka MD, Hirotoshi Akiyama MD, PhD & Itaru Endo MD

  3. Department of Biostatistics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Yusuke Saigusa PhD

Authors
  1. Hiroshi Miyamoto MD, PhD
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  2. Chikara Kunisaki MD, PhD
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  3. Sho Sato MD, PhD
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  4. Yusaku Tanaka MD
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  5. Kei Sato MD
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  6. Takashi Kosaka MD
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  7. Norio Yukawa MD, PhD
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  8. Hirotoshi Akiyama MD, PhD
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  9. Yusuke Saigusa PhD
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  10. Itaru Endo MD
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Corresponding author

Correspondence to Chikara Kunisaki MD, PhD.

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Supplementary material 1 (DOCX 13 kb)

Supplementary Fig. 1

Preoperative TVI assessed by the imaging modalities was correlated with the pathological TVI (r = 0.665, P < 0.001) (TIFF 107 kb)

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Miyamoto, H., Kunisaki, C., Sato, S. et al. Tumor Volume Index as a Prognostic Factor in Patients after Curative Esophageal Cancer Resection. Ann Surg Oncol 26, 1909–1915 (2019). https://doi.org/10.1245/s10434-019-07308-9

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  • DOI: https://doi.org/10.1245/s10434-019-07308-9

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