Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma

Lixia Liu, Wayne L. Hofstetter, Asif Rashid, Stephen G. Swisher, Arlene M. Correa, Jaffer A. Ajani, Stanley R. Hamilton, Tsung Teh Wu

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Abstract

Superficially invasive esophageal adenocarcinomas are a heterogeneous group of tumors, including rumors invading into mucosa and submucosa. The prognostic significance of the depth of tumor invasion and lymph node status in this group of patients remain unclear. We evaluated 90 consecutive patients with resected T1 adenocarcinoma of esophagus or esophagogastric junction. The T1 tumors were classified into four groups based on the depth of invasion: T1a, invading into lamina propria; T1b, into muscularis mucosae; T1c, into superficial submucosa; and T1d, into deep submucosa. The depth of tumor invasion was compared with clinicopathologic features. The depth of tumor invasion was significantly associated with the presence of lymph node metastasis (36% in T1d, 8% in T1c, 12% in T1b, and 0% in T1a; P < 0.001) and with tumor size (76% > 1.2 cm in T1d, 75% in T1c, 35% in T1b, and 25% in T1a; P < 0.001). The 5-year recurrence-free and overall survivals were significantly better in patients with tumors confined to mucosa (100% and 91%, respectively) than invasive into submucosa (60% and 58%; P = 0.0005 and P = 0.02, respectively). Lymph node metastasis was associated with tumor recurrence (P = 0.01) but not overall survival. Lymphovascular invasion was associated with both tumor recurrence (P = 0.001) and overall survival (P < 0.001) and was an independent prognostic factor in multivariate analysis (P = 0.04). Our study indicated evaluation of depth of tumor invasion, status of lymph nodes, and lymphovascular invasion is important in resected superficially invasive esophageal adenocarinoma and may provide supportive information for the decision about postoperative adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)1079-1085
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number8
StatePublished - Aug 2005
Externally publishedYes

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Adenocarcinoma
Lymph Nodes
Neoplasm Metastasis
Neoplasms
Mucous Membrane
Recurrence
Survival
Esophagogastric Junction
Multivariate Analysis

Keywords

  • Adenocarcinoma
  • Esophagus
  • Lymph node metastasis
  • Prognosis
  • Superficially invasive

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Liu, L., Hofstetter, W. L., Rashid, A., Swisher, S. G., Correa, A. M., Ajani, J. A., ... Wu, T. T. (2005). Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. American Journal of Surgical Pathology, 29(8), 1079-1085.

Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. / Liu, Lixia; Hofstetter, Wayne L.; Rashid, Asif; Swisher, Stephen G.; Correa, Arlene M.; Ajani, Jaffer A.; Hamilton, Stanley R.; Wu, Tsung Teh.

In: American Journal of Surgical Pathology, Vol. 29, No. 8, 08.2005, p. 1079-1085.

Research output: Contribution to journalArticle

Liu, L, Hofstetter, WL, Rashid, A, Swisher, SG, Correa, AM, Ajani, JA, Hamilton, SR & Wu, TT 2005, 'Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma', American Journal of Surgical Pathology, vol. 29, no. 8, pp. 1079-1085.
Liu, Lixia ; Hofstetter, Wayne L. ; Rashid, Asif ; Swisher, Stephen G. ; Correa, Arlene M. ; Ajani, Jaffer A. ; Hamilton, Stanley R. ; Wu, Tsung Teh. / Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. In: American Journal of Surgical Pathology. 2005 ; Vol. 29, No. 8. pp. 1079-1085.
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abstract = "Superficially invasive esophageal adenocarcinomas are a heterogeneous group of tumors, including rumors invading into mucosa and submucosa. The prognostic significance of the depth of tumor invasion and lymph node status in this group of patients remain unclear. We evaluated 90 consecutive patients with resected T1 adenocarcinoma of esophagus or esophagogastric junction. The T1 tumors were classified into four groups based on the depth of invasion: T1a, invading into lamina propria; T1b, into muscularis mucosae; T1c, into superficial submucosa; and T1d, into deep submucosa. The depth of tumor invasion was compared with clinicopathologic features. The depth of tumor invasion was significantly associated with the presence of lymph node metastasis (36{\%} in T1d, 8{\%} in T1c, 12{\%} in T1b, and 0{\%} in T1a; P < 0.001) and with tumor size (76{\%} > 1.2 cm in T1d, 75{\%} in T1c, 35{\%} in T1b, and 25{\%} in T1a; P < 0.001). The 5-year recurrence-free and overall survivals were significantly better in patients with tumors confined to mucosa (100{\%} and 91{\%}, respectively) than invasive into submucosa (60{\%} and 58{\%}; P = 0.0005 and P = 0.02, respectively). Lymph node metastasis was associated with tumor recurrence (P = 0.01) but not overall survival. Lymphovascular invasion was associated with both tumor recurrence (P = 0.001) and overall survival (P < 0.001) and was an independent prognostic factor in multivariate analysis (P = 0.04). Our study indicated evaluation of depth of tumor invasion, status of lymph nodes, and lymphovascular invasion is important in resected superficially invasive esophageal adenocarinoma and may provide supportive information for the decision about postoperative adjuvant therapy.",
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AU - Liu, Lixia

AU - Hofstetter, Wayne L.

AU - Rashid, Asif

AU - Swisher, Stephen G.

AU - Correa, Arlene M.

AU - Ajani, Jaffer A.

AU - Hamilton, Stanley R.

AU - Wu, Tsung Teh

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N2 - Superficially invasive esophageal adenocarcinomas are a heterogeneous group of tumors, including rumors invading into mucosa and submucosa. The prognostic significance of the depth of tumor invasion and lymph node status in this group of patients remain unclear. We evaluated 90 consecutive patients with resected T1 adenocarcinoma of esophagus or esophagogastric junction. The T1 tumors were classified into four groups based on the depth of invasion: T1a, invading into lamina propria; T1b, into muscularis mucosae; T1c, into superficial submucosa; and T1d, into deep submucosa. The depth of tumor invasion was compared with clinicopathologic features. The depth of tumor invasion was significantly associated with the presence of lymph node metastasis (36% in T1d, 8% in T1c, 12% in T1b, and 0% in T1a; P < 0.001) and with tumor size (76% > 1.2 cm in T1d, 75% in T1c, 35% in T1b, and 25% in T1a; P < 0.001). The 5-year recurrence-free and overall survivals were significantly better in patients with tumors confined to mucosa (100% and 91%, respectively) than invasive into submucosa (60% and 58%; P = 0.0005 and P = 0.02, respectively). Lymph node metastasis was associated with tumor recurrence (P = 0.01) but not overall survival. Lymphovascular invasion was associated with both tumor recurrence (P = 0.001) and overall survival (P < 0.001) and was an independent prognostic factor in multivariate analysis (P = 0.04). Our study indicated evaluation of depth of tumor invasion, status of lymph nodes, and lymphovascular invasion is important in resected superficially invasive esophageal adenocarinoma and may provide supportive information for the decision about postoperative adjuvant therapy.

AB - Superficially invasive esophageal adenocarcinomas are a heterogeneous group of tumors, including rumors invading into mucosa and submucosa. The prognostic significance of the depth of tumor invasion and lymph node status in this group of patients remain unclear. We evaluated 90 consecutive patients with resected T1 adenocarcinoma of esophagus or esophagogastric junction. The T1 tumors were classified into four groups based on the depth of invasion: T1a, invading into lamina propria; T1b, into muscularis mucosae; T1c, into superficial submucosa; and T1d, into deep submucosa. The depth of tumor invasion was compared with clinicopathologic features. The depth of tumor invasion was significantly associated with the presence of lymph node metastasis (36% in T1d, 8% in T1c, 12% in T1b, and 0% in T1a; P < 0.001) and with tumor size (76% > 1.2 cm in T1d, 75% in T1c, 35% in T1b, and 25% in T1a; P < 0.001). The 5-year recurrence-free and overall survivals were significantly better in patients with tumors confined to mucosa (100% and 91%, respectively) than invasive into submucosa (60% and 58%; P = 0.0005 and P = 0.02, respectively). Lymph node metastasis was associated with tumor recurrence (P = 0.01) but not overall survival. Lymphovascular invasion was associated with both tumor recurrence (P = 0.001) and overall survival (P < 0.001) and was an independent prognostic factor in multivariate analysis (P = 0.04). Our study indicated evaluation of depth of tumor invasion, status of lymph nodes, and lymphovascular invasion is important in resected superficially invasive esophageal adenocarinoma and may provide supportive information for the decision about postoperative adjuvant therapy.

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