Preoperative prognostic factors for squamous cell carcinomas of the thoracic esophagus

Aim of the study - To identify preoperative survival prognostic factors in patients with resectable squamous cell carcinoma of the thoracic esophagus. Population - From January 1982 to September 1999, 868 patients underwent su rgery for esophageal carcinoma in our department, including 493 for squamou s cell carcinoma of the thoracic esophagus. The following parameters were r etrospectively included in univariate and multivariate analysis: age, sex, undernutrition, dysphagia, tumor diameter and nodal involvement on the CT-s can, preoperative treatment, surgical technique, curative resection, pTNM c lassification, histologic type and postoperative complications. The actuari al survival was determined. Results - Survival prognostic factors were dysphagia, nodal involvement on CT-scan and depth of tumor invasion at pathological examination. Three grou ps of patients were identified on the two preoperative variables. group 1: patients without dysphagia (n = 102), group 2: patients with dysphagia but without nodal involvement on the CT-scan (n = 244), group 3: patients with dysphagia and with nodal involvement on the CT-scan (n = 147). The median s urvivals were 62.4, 19.1 and 14.4 months in groups 1, 2 and 3, respectively , and 5-year actuarial survivals were 50%, 21% and 11% (P < 0.009). Conclusion - Our study confirms that dysphagia and nodal involvement on the CT-scan are simple preoperative prognostic factors in patients with resect able squamous cell carcinoma of the thoracic esophagus.