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The prognostic significance of the circumferential resection margin in esophageal squamous cell carcinoma patients without neoadjuvant treatment

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单位: [1]Chinese Acad Med Sci & Peking Union Med Coll, Dept Pathol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing 100021, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Dept Med Record, Natl Canc Ctr,Natl Clin Res Ctr Canc, Beijing 100021, Peoples R China [3]Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc Canc Hosp, Dept Thorac Surg, Natl Canc Ctr, Beijing 100021, Peoples R China [4]Capital Med Univ, Beijing Chaoyang Hosp, Beijing 100021, Peoples R China [5]Yale Univ, Sch Med, Dept Pathol, 20 York St,East Pavil 2-608 C New Haven, New Haven, CT 06510 USA [6]Capital Med Univ, Beijing Friendship Hosp, Beijing 100021, Peoples R China
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关键词: Esophagus Squamous cell carcinoma Circumferential resection margin Prognosis

摘要:
Background Circumferential resection margin (CRM) is very important in esophageal cancer, but its diagnostic criteria has not been unified. The College of American Pathologists (CAP) and the Royal College of Pathologists (RCP) provide two different criteria. The aim of this study is to evaluate the long-term prognostic significance of CRM status with different CRM criteria in esophageal squamous cell carcinoma (ESCC). Methods Influence of CRM status according to the CAP and RCP criteria on long-term survival of 838 patients with resected pT3 tumors and without neoadjuvant therapy was analyzed. Patients stratified into three groups on the basis of tumor distance from the CRM (CRM > 1 mm, 0-1 mm, and 0 mm) were also analysed. Results Positive CRM was found in 59 (7%) patients according to the CAP criteria and 317 (37.8%) patients according to the RCP criteria. Univariate and multivariate survival analysis showed that CRM status, according to three different criteria, was independent prognostic factor. However, subgroup analysis showed that the prognostic value of CRM status was limited to certain metastatic lymph node load. In pN0 subgroup, patients with CRM > 1 mm had better prognosis than patients with CRM 0-1 mm. Patients with CRM 0 mm had worse outcome than patients with CRM > 0 mm in pN1-2 subgroup. But CRM status had no prognosis value in pN3 subgroup. Conclusions The CRM status is an important prognostic factor in ESCC patients, but this effect was limited to patients without or with less lymph node metastasis (pN0-2). In clinical practice, we recommend the 1 mm-three-tier criteria as it provides more prognostic value than the traditional two-tier criteria.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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出版当年[2020]版:
Q2 ONCOLOGY
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Q2 ONCOLOGY

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第一作者单位: [1]Chinese Acad Med Sci & Peking Union Med Coll, Dept Pathol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing 100021, Peoples R China
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