Ren ZT, Kang M, Zhu LY, Li P. Long-term survival and risk factors in esophageal squamous cell carcinoma: A Kaplan-Meier and cox regression study. World J Gastrointest Surg 2024; 16(12): 3772-3779 [DOI: 10.4240/wjgs.v16.i12.3772]
Corresponding Author of This Article
Ping Li, MD, Chief Physician, Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, No. 120 Wanshui Road, Shushan District, Hefei 230022, Anhui Province, China. liping64@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3772-3779 Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3772
Long-term survival and risk factors in esophageal squamous cell carcinoma: A Kaplan-Meier and cox regression study
Zheng-Ting Ren, Mei Kang, Li-Yang Zhu, Ping Li
Zheng-Ting Ren, Mei Kang, Li-Yang Zhu, Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Ping Li, Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Ren ZT was responsible for writing of original draft, collect information, conceptualization and formal analysis; Kang M was responsible for resources, supervision and methodology; Zhu LY was responsible for formal analysis, investigation and validation; Li P was responsible for writing-review and editing.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Anhui Medical University Institutional Review Board.
Informed consent statement: All study participants provided informed written consent before study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping Li, MD, Chief Physician, Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, No. 120 Wanshui Road, Shushan District, Hefei 230022, Anhui Province, China. liping64@sina.com
Received: August 20, 2024 Revised: September 10, 2024 Accepted: September 12, 2024 Published online: December 27, 2024 Processing time: 99 Days and 1.3 Hours
Abstract
BACKGROUND
The global incidence of esophageal cancer (EC) remains high. Despite advancements in medical technology and deeper research into the causes and treatment methods of EC, the effectiveness of treatment for EC is still unsatisfactory. Therefore, it is crucial to address the urgent problem of improving the long-term survival rate of EC patients and providing personalized treatment.
AIM
To analyze the survival prognosis and influencing factors of esophageal squamous cell carcinoma (ESCC).
METHODS
A retrospective analysis was conducted on the clinical data of 115 patients with pT3N0M0 ESCC who underwent radical surgery alone from January 1, 2013, to December 31, 2019. The Kaplan–Meier method was used to evaluate the 1-year, 3-year, and 5-year survival rates and median survival time of the patients. The Cox proportional hazards regression model was used to assess the hazard ratios (HRs) and 95% confidence intervals (95%CIs) of risk factors.
RESULTS
The 1-year, 3-year, and 5-year overall survival (OS) rates for the 115 EC patients analyzed were 85.22%, 50.43%, and 37.48%, respectively. The median OS was 37.00 (95%CI: 24.93-49.07) months, and the median disease-free survival was 21.00 (95%CI: 14.71-27.29) months. Both univariate and multivariate Cox regression analyses revealed that high body mass index (BMI; HR = 1.137, 95%CI: 1.054-1.226), positive perineural invasion (PNI; HR = 13.381, 95%CI: 4.899-36.547), and smoking (HR = 2.415, 95%CI: 1.388-4.203) were independent risk factors for a poor prognosis. In contrast, compared to the upper thoracic location of the tumor, middle thoracic (HR = 0.441, 95%CI: 0.240-0.810) and lower thoracic (HR = 0.328, 95%CI: 0.144-0.750) locations were protective factors.
CONCLUSION
BMI, tumor location, PNI, and smoking are associated with the prognosis of ESCC patients. This study highlights the prognostic risk factors for T3N0M0 ESCC patients and offers personalized insights for clinical treatment.
Core Tip: Esophageal squamous cell carcinoma (ESCC) has a relatively high incidence globally, imposing a significant societal burden. This study conducted a survival analysis on 115 patients with T3N0M0 stage ESCC and found that high body mass index, tumor location, positive perineural invasion and smoking were associated with the prognosis of ESCC patients. In the future, prospective multi-center hospital studies need to be carried out to confirm the risk factors affecting prognosis, with a view to providing individualized and standardized treatment measures after surgery.
