Endoscopic tumour morphology impacts survival in adenocarcinoma of the oesophagus

Prognostication in oesophageal cancer on the basis of preoperative variables is challenging. Many of the accepted predictors of survival are only derived after surgical treatment and may be influenced by neoadjuvant therapy. This study aims to explore the relationship between pre-treatment endoscopi...

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Published in:European journal of surgical oncology 2020-12, Vol.46 (12), p.2257-2261
Main Authors: Knight, William R.C., McEwen, Ricardo, Byrne, Ben E., Habib, Wais, Bott, Rebecca, Zylstra, Janine, Mahadeva, Ula, Gossage, James A., Fitzgerald, R.C., Noorani, A., Edwards, P.A.W., Grehan, N., Nutzinger, B., Hughes, C., Fidziukiewicz, E., MacRae, S., Northrop, A., Contino, G., Li, X., de la Rue, R., Katz-Summercorn, A., Abbas, S., Loureda, D., O'Donovan, M., Miremadi, A., Malhotra, S., Tripathi, M., Tavaré, S., Lynch, A.G., Eldridge, M., Secrier, M., Devonshire, G., Perner, J., Jammula, S., Davies, J., Crichton, C., Carroll, N., Safranek, P., Hindmarsh, A., Sujendran, V., Hayes, S.J., Ang, Y., Sharrocks, A., Preston, S.R., Oakes, S., Bagwan, I., Save, V., Skipworth, R.J.E., Hupp, T.R., O'Neill, J.R., Tucker, O., Beggs, A., Taniere, P., Puig, S., Underwood, T.J., Walker, R.C., Grace, B.L., Barr, H., Shepherd, N., Old, O., Lagergren, J., Davies, A., Chang, F., Goh, V., Ciccarelli, F.D., Sanders, G., Berrisford, R., Harden, C., Lewis, M., Cheong, E., Kumar, B., Parsons, S.L., Soomro, I., Kaye, P., Saunders, J., Lovat, L., Haidry, R., Igali, L., Scott, M., Sothi, S., Suortamo, S., Lishman, S., Hanna, G.B., Moorthy, K., Peters, C.J., Grabowska, A., Turkington, R., McManus, D., Coleman, H., Khoo, D., Fickling, W.
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Constriction, Pathologic - pathology
Endoscopic tumour morphology
Endoscopy, Digestive System
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagectomy
Esophagogastric Junction - pathology
Exophytic tumour
Humans
Kaplan-Meier Estimate
Lymph Nodes - pathology
Margins of Excision
Medicin och hälsovetenskap
Multivariate Analysis
Neoadjuvant Therapy
Neoplasm Grading
Neoplasm Invasiveness
Neoplasm Staging
Oesophageal cancer
Oesophagectomy
Polyps - pathology
Prognosis
Proportional Hazards Models
Stenosing tumour
Stricturing tumour
Survival Rate
Tumor Burden
Ulcer - pathology
Ulcerating tumour
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Summary:Prognostication in oesophageal cancer on the basis of preoperative variables is challenging. Many of the accepted predictors of survival are only derived after surgical treatment and may be influenced by neoadjuvant therapy. This study aims to explore the relationship between pre-treatment endoscopic tumour morphology and postoperative survival. Patients with endoscopic descriptions of tumours were identified from the prospectively managed databases including the OCCAMS database. Tumours were classified as exophytic, ulcerating or stenosing. Kaplan Meier survival analysis and multivariable Cox regression analyses were performed to determine hazard ratios (HR) with 95% confidence intervals. 262 patients with oesophageal adenocarcinoma undergoing potentially curative resection were pooled from St Thomas’ Hospital (161) and the OCCAMS database (101). There were 70 ulcerating, 114 exophytic and 78 stenosing oesophageal adenocarcinomas. Initial tumour staging was similar across all groups (T3/4 tumours 71.4%, 70.2%, 74.4%). Median survival was 55 months, 51 months and 36 months respectively (p 
ISSN:0748-7983
1532-2157
1532-2157
DOI:10.1016/j.ejso.2020.07.003