Computed tomography overestimation of esophageal tumor length: Implications for radiotherapy planning

Table 1 Summary of clinicopathological factors and relationship with CT tumor length

Variable	n	P
Mean tumor length (range) (cm)
4.2 (0-11.5)
Median age (range) years (yr)
65 (36-82)	56	0.121
Gender
Male	48	0.922
Female	8
Neoadjuvant chemotherapy3
No	19	0.644
Yes	37
Tumor type
Adenocarcinoma	56
Tumor morphology
Polypoidal	14	0.074
Stenosing	15
Ulcerating	27
Differentiation
Well	4	0.361
Moderate	32
Poor	20
T-stage
T1	8	0.181
T2	13
T3	34
T4	1
N-stage
N0	19	0.122
N1	37
M-stage
M0	54
M1a	2
Resection category
R0	47	0.222
R1	9

CT: Computed tomography; R₀: Both macroscopic and microscopic clearance of the longitudinal resection margins; R₁: Microscopic evidence of tumor at the longitudinal resection margins;

¹Spearman’s;

²Mann-Whitney;

³CT scans were carried out following neo-adjuvant chemotherapy;

⁴ANOVA.

Table 2 Radiological parameters and relationship with CT tumor length

Variable	n	P
Mean tumor length (range)/(cm)
5.9 (0-15)	56
Mean maximum esophageal thickness (range)/(cm)
3.1 (1.7-4.7)	56	0.011
Mean slice thickness (range)/(mm)
5.5 (4-10)	56	0.25
Presence of hiatus hernia
Yes	9	0.762
No	47
Degree of esophageal distension
Good	16	0.831
Moderate	16
Poor	24
Degree of gastric distension
Good	23	0.741
Moderate	22
Poor	11

¹Spearman’s;

²Mann-Whitney.

Table 3 Two separate tumor lengths readings measured by two radiologists with the corresponding pathology lengths

Patient	Pathology	1st reading of Radiologist 1	2nd reading of Radiologist 1	1st reading of Radiologist 2	2nd reading of Radiologist 2
1	3.0	5.0	5.0	5.0	6.0
2	5.0	5.3	8.1	6.7	4.6
3	5.0	7.0	6.5	7.0	8.0
4	1.5	2.4	3.4	3.5	4.0
5	4.0	9.1	8.4	8.4	3.5
6	4.0	5.0	4.5	4.5	4.0
7	2.7	4.2	4.2	3.0	3.0
8	4.2	5.6	4.9	4.2	4.9
9	7.0	8.4	8.4	9.1	9.3
10	0	6.5	5.5	8.0	7.0
11	4.0	6.6	6.6	6.2	6.6
12	3.5	5.6	4.9	6.3	5.8
13	5.5	9.1	10.3	10.3	11.6
14	4.0	7.3	5.9	9.4	6.7

Measurements are in cm.