PROGNOSIS OF OPERABLE SQUAMOUS-CELL CARCINOMA OF THE ESOPHAGUS - RELATIONSHIP WITH CLINICOPATHOLOGICAL FEATURES AND DNA-PLOIDY

Background. Reports on the influence of various prognostic factors in carcinoma of the esophagus are conflicting. The prognostic value of a set of clinicopathologic factors and DNA ploidy were examined in 74 pa tients with surgically resected squamous cell carcinoma of the lower a nd middle third of the esophagus. Methods. All patients had surgery pe rformed in a single thoracic surgical unit at the Tata Memorial Hospit al between January, 1984 and December, 1987. The clinicopathologic fac tors studied were (1) gross residual disease at operation; (2) morphol ogy of the tumor; (3) depth of microscopic invasion; (4) lymph node in volvement; (5) histologic grade; (6) vascular and lymphatic embolism; and (7) sex. DNA ploidy and S-phase fraction (SpF) were determined by flow cytometry on archival tissues extracted from paraffin blocks. Plo idy status could be determined successfully in all 74 tumors, whereas SpF could be assessed only in 25. Results. Of the various prognostic f actors examined with the Cox stepwise regression model, residual disea se (P = 0.000), depth of invasion (P = 0.047), and lymph node status ( P = 0.077) were found to be correlated with overall survival. Conclusi ons. DNA ploidy was not related to prognosis. The overall survival of this group of patients at 36 months was 28%, and median survival was 1 8 months.