Survival based radiographic-grouping for esophageal squamous cell carcinoma may impact clinical T stage
Most patients diagnosed with thoracic esophageal squamous cell carcinoma (ESCC) have progressed beyond surgical resection as a therapeutic option. Difficulties in the proper assessment of tumor invasion depth before treatment complicate determination of the type and extent of therapy. Therefore, acc...
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Published in | Oncotarget Vol. 9; no. 10; pp. 9512 - 9530 |
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Abstract | Most patients diagnosed with thoracic esophageal squamous cell carcinoma (ESCC) have progressed beyond surgical resection as a therapeutic option. Difficulties in the proper assessment of tumor invasion depth before treatment complicate determination of the type and extent of therapy. Therefore, accurate tumor clinical staging is a necessity for identifying treatment options and aiding in patient prognosis. We investigated radiographic factors as prognostic indicators for survival in ESCC. Between July 2006 - July 2010, 324 thoracic ESCC patients who underwent surgery were selected. All patients received contrast enhanced preoperative chest CT scans and esophageal barium swallow examinations. Measurement of maximal lesion cross-sectional area, the largest long diameter, largest short diameter, CT-indicated lesion length, barium-indicated lesion length and the length of pericardial fat reduction were performed. Relationships between these indicators and post-surgical survival time and the cutoff values of related factors were analyzed. Maximum long diameter, maximum lesion area and lesion length, as measured by CT imaging, were correlated with survival. Survival effects were clearly associated with group intervals, calculated by a genetic algorithm, and tumor stages. Risk-stratification intervals of esophageal lesions from radiographic imaging included: maximum long diameter < 28.7, 28.7-34.6mm, 34.6-41.4mm and >41.4mm; maximum lesion area < 355.8mm
, 355.8-568.0mm
, 568.0-907.3mm
and >907.3mm
; and CT-indicated lesion length <30.9mm, 30.9-57.3mm, 57.3-70.6mm and > 70.6mm. The reasonable stratification of maximum esophageal lesion area, largest long diameter and lesion length measured in CT is valuable for clinical T staging of ESCC. Radiographic parameters may have prognostic clinical value in the staging of esophageal carcinoma. |
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AbstractList | Most patients diagnosed with thoracic esophageal squamous cell carcinoma (ESCC) have progressed beyond surgical resection as a therapeutic option. Difficulties in the proper assessment of tumor invasion depth before treatment complicate determination of the type and extent of therapy. Therefore, accurate tumor clinical staging is a necessity for identifying treatment options and aiding in patient prognosis. We investigated radiographic factors as prognostic indicators for survival in ESCC. Between July 2006 - July 2010, 324 thoracic ESCC patients who underwent surgery were selected. All patients received contrast enhanced preoperative chest CT scans and esophageal barium swallow examinations. Measurement of maximal lesion cross-sectional area, the largest long diameter, largest short diameter, CT-indicated lesion length, barium-indicated lesion length and the length of pericardial fat reduction were performed. Relationships between these indicators and post-surgical survival time and the cutoff values of related factors were analyzed. Maximum long diameter, maximum lesion area and lesion length, as measured by CT imaging, were correlated with survival. Survival effects were clearly associated with group intervals, calculated by a genetic algorithm, and tumor stages. Risk-stratification intervals of esophageal lesions from radiographic imaging included: maximum long diameter < 28.7, 28.7-34.6mm, 34.6-41.4mm and >41.4mm; maximum lesion area < 355.8mm
2
, 355.8-568.0mm
2
, 568.0-907.3mm
2
and >907.3mm
2
; and CT-indicated lesion length <30.9mm, 30.9-57.3mm, 57.3-70.6mm and > 70.6mm. The reasonable stratification of maximum esophageal lesion area, largest long diameter and lesion length measured in CT is valuable for clinical T staging of ESCC. Radiographic parameters may have prognostic clinical value in the staging of esophageal carcinoma. Most patients diagnosed with thoracic esophageal squamous cell carcinoma (ESCC) have progressed beyond surgical resection as a therapeutic option. Difficulties in the proper assessment of tumor invasion depth before treatment complicate determination of the type and extent of therapy. Therefore, accurate tumor clinical staging is a necessity for identifying treatment options and aiding in patient prognosis. We investigated radiographic factors as prognostic indicators for survival in ESCC. Between July 2006 - July 2010, 324 thoracic ESCC patients who underwent surgery were selected. All patients received contrast enhanced preoperative chest CT scans and esophageal barium swallow examinations. Measurement of maximal lesion cross-sectional area, the largest long diameter, largest short diameter, CT-indicated lesion length, barium-indicated lesion length and the length of pericardial fat reduction were performed. Relationships between these indicators and post-surgical survival time and the cutoff values of related factors were analyzed. Maximum long diameter, maximum lesion area and lesion length, as measured by CT imaging, were correlated with survival. Survival effects were clearly associated with group intervals, calculated by a genetic algorithm, and tumor stages. Risk-stratification intervals of esophageal lesions from radiographic imaging included: maximum long diameter < 28.7, 28.7-34.6mm, 34.6-41.4mm and >41.4mm; maximum lesion area < 355.8mm , 355.8-568.0mm , 568.0-907.3mm and >907.3mm ; and CT-indicated lesion length <30.9mm, 30.9-57.3mm, 57.3-70.6mm and > 70.6mm. The reasonable stratification of maximum esophageal lesion area, largest long diameter and lesion length measured in CT is valuable for clinical T staging of ESCC. Radiographic parameters may have prognostic clinical value in the staging of esophageal carcinoma. Most patients diagnosed with thoracic esophageal squamous cell carcinoma (ESCC) have progressed beyond surgical resection as a therapeutic option. Difficulties in the proper assessment of tumor invasion depth before treatment complicate determination of the type and extent of therapy. Therefore, accurate tumor clinical staging is a necessity for identifying treatment options and aiding in patient prognosis. We investigated radiographic factors as prognostic indicators for survival in ESCC. Between July 2006 - July 2010, 324 thoracic ESCC patients who underwent surgery were selected. All patients received contrast enhanced preoperative chest CT scans and esophageal barium swallow examinations. Measurement of maximal lesion cross-sectional area, the largest long diameter, largest short diameter, CT-indicated lesion length, barium-indicated lesion length and the length of pericardial fat reduction were performed. Relationships between these indicators and post-surgical survival time and the cutoff values of related factors were analyzed. Maximum long diameter, maximum lesion area and lesion length, as measured by CT imaging, were correlated with survival. Survival effects were clearly associated with group intervals, calculated by a genetic algorithm, and tumor stages. Risk-stratification intervals of esophageal lesions from radiographic imaging included: maximum long diameter < 28.7, 28.7-34.6mm, 34.6-41.4mm and >41.4mm; maximum lesion area < 355.8mm2, 355.8-568.0mm2, 568.0-907.3mm2 and >907.3mm2; and CT-indicated lesion length <30.9mm, 30.9-57.3mm, 57.3-70.6mm and > 70.6mm. The reasonable stratification of maximum esophageal lesion area, largest long diameter and lesion length measured in CT is valuable for clinical T staging of ESCC. Radiographic parameters may have prognostic clinical value in the staging of esophageal carcinoma. |
Author | Yang, Xiyang Xin, Peiling Xin, Jun Gao, Bingzhong Cai, Wenjie Chen, Yayun Lu, Jiade J Xu, Rongyu Chen, Jieyun |
AuthorAffiliation | 4 Department of Surgery, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China 2 Shanghai Proton and Heavy Ion Center, Shanghai 201315, P. R. China 5 Department of Radiology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China 1 Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China 6 Key Laboratory of Intelligent Computing and Information Processing, Quanzhou Normal University, Quanzhou 362000, P. R. China 3 Department of Surgical Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China |
AuthorAffiliation_xml | – name: 1 Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – name: 4 Department of Surgery, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – name: 5 Department of Radiology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – name: 3 Department of Surgical Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – name: 6 Key Laboratory of Intelligent Computing and Information Processing, Quanzhou Normal University, Quanzhou 362000, P. R. China – name: 2 Shanghai Proton and Heavy Ion Center, Shanghai 201315, P. R. China |
Author_xml | – sequence: 1 givenname: Wenjie surname: Cai fullname: Cai, Wenjie organization: Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 2 givenname: Jiade J surname: Lu fullname: Lu, Jiade J organization: Shanghai Proton and Heavy Ion Center, Shanghai 201315, P. R. China – sequence: 3 givenname: Rongyu surname: Xu fullname: Xu, Rongyu organization: Department of Surgical Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 4 givenname: Peiling surname: Xin fullname: Xin, Peiling organization: Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 5 givenname: Jun surname: Xin fullname: Xin, Jun organization: Department of Surgery, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 6 givenname: Yayun surname: Chen fullname: Chen, Yayun organization: Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 7 givenname: Bingzhong surname: Gao fullname: Gao, Bingzhong organization: Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 8 givenname: Jieyun surname: Chen fullname: Chen, Jieyun organization: Department of Radiology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, P. R. China – sequence: 9 givenname: Xiyang surname: Yang fullname: Yang, Xiyang organization: Key Laboratory of Intelligent Computing and Information Processing, Quanzhou Normal University, Quanzhou 362000, P. R. China |
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Cites_doi | 10.2214/ajr.136.6.1051 10.1102/1470-7330.2006.0032 10.3748/wjg.v9.i2.219 10.3978/j.issn.2072-1439.2014.03.11 10.1136/bmj.b929 10.3322/caac.21262 10.1002/jso.20569 10.1102/1470-7330.2005.0020 10.1148/rg.276065742 10.2188/jea.16.185 10.1016/j.ypmed.2016.09.027 10.1016/j.radonc.2015.07.007 10.1002/cncr.10868 10.1093/jnci/92.3.205 10.2214/ajr.141.5.951 10.1016/S0003-4975(99)00031-4 10.1093/aje/kwm051 10.1055/s-0033-1344024 10.21037/jtd.2016.03.49 10.1111/j.1572-0241.1999.00767.x 10.1111/dote.12493 10.1016/j.crad.2011.08.012 10.1016/S0277-9536(00)00402-0 10.1371/journal.pone.0158373 10.1148/rg.346130079 10.1016/j.athoracsur.2015.05.038 10.2214/ajr.140.5.931 10.1016/j.gie.2011.09.016 10.1097/00000658-197207000-00007 10.1002/ijc.29890 10.1371/journal.pone.0153068 10.1046/j.1442-2050.1999.00039.x 10.1016/j.athoracsur.2010.11.011 10.1245/s10434-012-2273-y 10.3109/03009734.2013.792887 10.1700/1088.11929 10.1016/j.suc.2005.01.012 10.1002/ijc.24445 10.1111/ajco.12503 10.3322/caac.21339 10.3748/wjg.14.1479 10.1007/978-3-319-40618-3_16 |
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Keywords | CT esophageal cancer imaging prognosis tumor staging |
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Title | Survival based radiographic-grouping for esophageal squamous cell carcinoma may impact clinical T stage |
URI | https://www.ncbi.nlm.nih.gov/pubmed/29507707 https://search.proquest.com/docview/2011273974 https://pubmed.ncbi.nlm.nih.gov/PMC5823661 |
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