Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma

Christopher W. Seder, Brett Mahon, Mark Hennon, Mathew Thomas, Charles M. Levea, Kristina A. Matkowskyj, Murli Krishna, Robert Medairos, Ryan A. Macke, Sanjib Basu, Justin D. Blasberg

Research output: Contribution to journalArticle

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Abstract

Aim: Although tumor depth of invasion is strongly associated with risk of lymph node metastasis and long-term survival in patients with esophageal adenocarcinoma, the significance of differential T2 invasion (inner circular layer versus outer longitudinal layer) is unknown. The current study was undertaken to explore the hypothesis that greater T2-specific depth of invasion is associated with inferior long-term outcomes in patients with esophageal adenocarcinoma treated with esophagectomy. Patients and Methods: Demographic, treatment, and outcome data were collected for patients with resected pT2N0-3M0 esophageal adenocarcinoma treated between 2005 and 2015 pooled from four U.S. academic medical centers. Two blinded pathologists evaluated depth of muscularis propria tumor invasion. Univariate and Cox proportional hazard regression analyses were performed to identify prognostic factors for overall (OS) and disease-free (DFS) survival, and Kaplan–Meier analysis to compare survival differences specific to prognostic factors. Results: A total of 84 patients were identified for analysis (53 with circular invasion; 31 with longitudinal invasion), with a median age of 66 years. Sixty percent of patients (50/84) received induction therapy prior to esophagectomy. The median OS and DFS was 58 months (95% confidence interval(CI)=42 months-not reached) and 27 months (95% CI=13.7-66 months) respectively. Depth of muscularis propria invasion did not correlate with OS or DFS on univariate (p=0.42; and p=0.34, respectively) or multivariate (p=0.15 and p=0.21, respectively) analysis after adjustment for age, nodal status, perineural invasion, and tumor grade. These findings did not vary by induction therapy status. Conclusion: Depth of muscularis propria invasion does not appear to correlate with survival in patients with esophageal adenocarcinoma.

Original languageEnglish (US)
Pages (from-to)2195-2200
Number of pages6
JournalAnticancer Research
Volume38
Issue number4
DOIs
StatePublished - Apr 1 2018

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Adenocarcinoma
Survival
Esophagectomy
Confidence Intervals
Neoplasms
Survival Analysis
Disease-Free Survival
Lymph Nodes
Regression Analysis
Demography
Neoplasm Metastasis
Therapeutics

Keywords

  • Adenocarcinoma
  • Esophageal cancer
  • Outcomes.

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Seder, C. W., Mahon, B., Hennon, M., Thomas, M., Levea, C. M., Matkowskyj, K. A., ... Blasberg, J. D. (2018). Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma. Anticancer Research, 38(4), 2195-2200. https://doi.org/10.21873/anticanres.12461

Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma. / Seder, Christopher W.; Mahon, Brett; Hennon, Mark; Thomas, Mathew; Levea, Charles M.; Matkowskyj, Kristina A.; Krishna, Murli; Medairos, Robert; Macke, Ryan A.; Basu, Sanjib; Blasberg, Justin D.

In: Anticancer Research, Vol. 38, No. 4, 01.04.2018, p. 2195-2200.

Research output: Contribution to journalArticle

Seder, CW, Mahon, B, Hennon, M, Thomas, M, Levea, CM, Matkowskyj, KA, Krishna, M, Medairos, R, Macke, RA, Basu, S & Blasberg, JD 2018, 'Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma', Anticancer Research, vol. 38, no. 4, pp. 2195-2200. https://doi.org/10.21873/anticanres.12461
Seder, Christopher W. ; Mahon, Brett ; Hennon, Mark ; Thomas, Mathew ; Levea, Charles M. ; Matkowskyj, Kristina A. ; Krishna, Murli ; Medairos, Robert ; Macke, Ryan A. ; Basu, Sanjib ; Blasberg, Justin D. / Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma. In: Anticancer Research. 2018 ; Vol. 38, No. 4. pp. 2195-2200.
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abstract = "Aim: Although tumor depth of invasion is strongly associated with risk of lymph node metastasis and long-term survival in patients with esophageal adenocarcinoma, the significance of differential T2 invasion (inner circular layer versus outer longitudinal layer) is unknown. The current study was undertaken to explore the hypothesis that greater T2-specific depth of invasion is associated with inferior long-term outcomes in patients with esophageal adenocarcinoma treated with esophagectomy. Patients and Methods: Demographic, treatment, and outcome data were collected for patients with resected pT2N0-3M0 esophageal adenocarcinoma treated between 2005 and 2015 pooled from four U.S. academic medical centers. Two blinded pathologists evaluated depth of muscularis propria tumor invasion. Univariate and Cox proportional hazard regression analyses were performed to identify prognostic factors for overall (OS) and disease-free (DFS) survival, and Kaplan–Meier analysis to compare survival differences specific to prognostic factors. Results: A total of 84 patients were identified for analysis (53 with circular invasion; 31 with longitudinal invasion), with a median age of 66 years. Sixty percent of patients (50/84) received induction therapy prior to esophagectomy. The median OS and DFS was 58 months (95{\%} confidence interval(CI)=42 months-not reached) and 27 months (95{\%} CI=13.7-66 months) respectively. Depth of muscularis propria invasion did not correlate with OS or DFS on univariate (p=0.42; and p=0.34, respectively) or multivariate (p=0.15 and p=0.21, respectively) analysis after adjustment for age, nodal status, perineural invasion, and tumor grade. These findings did not vary by induction therapy status. Conclusion: Depth of muscularis propria invasion does not appear to correlate with survival in patients with esophageal adenocarcinoma.",
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T1 - Depth of muscularis propria invasion does not prognosticate survival in T2 esophageal adenocarcinoma

AU - Seder, Christopher W.

AU - Mahon, Brett

AU - Hennon, Mark

AU - Thomas, Mathew

AU - Levea, Charles M.

AU - Matkowskyj, Kristina A.

AU - Krishna, Murli

AU - Medairos, Robert

AU - Macke, Ryan A.

AU - Basu, Sanjib

AU - Blasberg, Justin D.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Aim: Although tumor depth of invasion is strongly associated with risk of lymph node metastasis and long-term survival in patients with esophageal adenocarcinoma, the significance of differential T2 invasion (inner circular layer versus outer longitudinal layer) is unknown. The current study was undertaken to explore the hypothesis that greater T2-specific depth of invasion is associated with inferior long-term outcomes in patients with esophageal adenocarcinoma treated with esophagectomy. Patients and Methods: Demographic, treatment, and outcome data were collected for patients with resected pT2N0-3M0 esophageal adenocarcinoma treated between 2005 and 2015 pooled from four U.S. academic medical centers. Two blinded pathologists evaluated depth of muscularis propria tumor invasion. Univariate and Cox proportional hazard regression analyses were performed to identify prognostic factors for overall (OS) and disease-free (DFS) survival, and Kaplan–Meier analysis to compare survival differences specific to prognostic factors. Results: A total of 84 patients were identified for analysis (53 with circular invasion; 31 with longitudinal invasion), with a median age of 66 years. Sixty percent of patients (50/84) received induction therapy prior to esophagectomy. The median OS and DFS was 58 months (95% confidence interval(CI)=42 months-not reached) and 27 months (95% CI=13.7-66 months) respectively. Depth of muscularis propria invasion did not correlate with OS or DFS on univariate (p=0.42; and p=0.34, respectively) or multivariate (p=0.15 and p=0.21, respectively) analysis after adjustment for age, nodal status, perineural invasion, and tumor grade. These findings did not vary by induction therapy status. Conclusion: Depth of muscularis propria invasion does not appear to correlate with survival in patients with esophageal adenocarcinoma.

AB - Aim: Although tumor depth of invasion is strongly associated with risk of lymph node metastasis and long-term survival in patients with esophageal adenocarcinoma, the significance of differential T2 invasion (inner circular layer versus outer longitudinal layer) is unknown. The current study was undertaken to explore the hypothesis that greater T2-specific depth of invasion is associated with inferior long-term outcomes in patients with esophageal adenocarcinoma treated with esophagectomy. Patients and Methods: Demographic, treatment, and outcome data were collected for patients with resected pT2N0-3M0 esophageal adenocarcinoma treated between 2005 and 2015 pooled from four U.S. academic medical centers. Two blinded pathologists evaluated depth of muscularis propria tumor invasion. Univariate and Cox proportional hazard regression analyses were performed to identify prognostic factors for overall (OS) and disease-free (DFS) survival, and Kaplan–Meier analysis to compare survival differences specific to prognostic factors. Results: A total of 84 patients were identified for analysis (53 with circular invasion; 31 with longitudinal invasion), with a median age of 66 years. Sixty percent of patients (50/84) received induction therapy prior to esophagectomy. The median OS and DFS was 58 months (95% confidence interval(CI)=42 months-not reached) and 27 months (95% CI=13.7-66 months) respectively. Depth of muscularis propria invasion did not correlate with OS or DFS on univariate (p=0.42; and p=0.34, respectively) or multivariate (p=0.15 and p=0.21, respectively) analysis after adjustment for age, nodal status, perineural invasion, and tumor grade. These findings did not vary by induction therapy status. Conclusion: Depth of muscularis propria invasion does not appear to correlate with survival in patients with esophageal adenocarcinoma.

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KW - Esophageal cancer

KW - Outcomes.

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