Abstract
Background: T1N0 tumor of the alimentary tract has an excellent long-term prognosis, however, the prognosis of T2N0 tumor has not been uniformly elucidated. Material and Methods: Between February 1981 and April 2000, 75, 424 and 327 patients with node-negative esophageal, gastric and colorectal carcinomas, respectively, underwent curative resection and were included in this study. Long-term prognosis of those node-negative patients stratified by the T-stage were evaluated retrospectively. Results: The 5-year survival rates of patients with T1N0 and T2N0 esophageal tumors were 95.7 and 93.3%, respectively, however those with T3N0 tumor was only 47.6% (p < 0.01). Similarly, the 5-year survival rates of gastric cancer patients with T1–2N0 tumors was 100%, however those with T3N0 and T4N0 tumors were 55.6 and 44.4%, respectively (p < 0.01). The 5-year survival rates of colorectal cancer patients with T1N0 and T2N0 tumors were 97.3 and 97.5%, respectively. In contrast, those with T3N0 and T4N0 tumors were 78.6 and 58.3%, respectively (p < 0.05, T1N0, T2N0 vs. T3N0; p < 0.001, vs. T4N0). Conclusion: Patients with T2N0 tumors have an excellent long-term prognosis like T1N0 tumors and both categories could be classified as early cancer in the alimentary tract cancers.
Journal Section:
Original Paper: Gastrointestinal Oncology
References
1.
Tachibana M, Yoshimura H, Kinugasa S, Hashimoto N, Dhar DK, Abe S, Monden N, Nagasue N: Clinicopathological features of superficial squamous cell carcinoma of the esophagus. Am J Surg 1997;174:49–53.
[PubMed]
2.
Tachibana M, Takemoto Y, Monden N, Nakashima Y, Kinugasa S, Dhar DK, Kotoh T, Kubota H, Kohno H, Nagasue N: Clinicopathological features of early gastric cancer: Results of 100 cases from a rural general hospital. Eur J Surg 1999;165:319–325.
[PubMed]
3.
Jessup JM, Stewart AK, Menck HR: The national cancer data base report on patterns of care for adenocarcinoma of the rectum, 1985–1995. Cancer 1998;83:2408–2418.
[PubMed]
4.
Jessup JM, McGinnis LS, Steele GD Jr, Menck HR, Winchester DP: The National Cancer Data Base. Report on colon cancer. Cancer 1996;78:918–926.
[PubMed]
5.
Dukes CE: The classification of cancer of the rectum. J Pathol 1932;32:323–332.
6.
Steele GD: The National Cancer Data Base report on colorectal cancer. Cancer 1994;74:1979–1989.
[PubMed]
7.
Deans GT, Parks TG, Rowlands BJ, Spence RAJ: Prognostic factors in colorectal cancer. Br J Surg 1992;79:608–613.
[PubMed]
8.
Adachi Y, Mori M, Maehara Y, Sugimachi K: Dukes’ classification: A valid prognostic indicator for gastric cancer. Gut 1994;35:1368–1371.
[PubMed]
9.
Tachibana M, Kinugasa S, Dhar DK, Yoshimura H, Shibakita M, Ohno S, Ueda S, Kubota H, Kohno H, Nagasue N: Dukes’ classification as a useful staging system in resectable squamous cell carcinoma of the esophagus. Virchows Arch 2001;438:350–356.
[PubMed]
10.
UICC Staff: TNM Classification of Malignant Tumours, ed 5. New York, Willey-Liss, 1997.
11.
Kaplan EL, Meier P: Nonparametric estimation for incomplete observations. J Am Stat Assoc 1958;53:457–481.
12.
Yoshinaka H, Shimazu H, Fukumoto T, Baba M: Superficial esophageal carcinoma: A clinicopathological review of 59 cases. Am J Gastroenterol 1991;86:1413–1418.
[PubMed]
13.
Kato H, Tachimori Y, Watanabe H et al: Superficial esophageal carcinoma: Surgical treatment and the results. Cancer 1990;66:2319–2323.
[PubMed]
14.
Sugimachi K, Kitamura K, Matsuda H, Mori M, Kuwano H, Ide H: Proposed new criteria for early carcinoma of the esophagus. Surg Gynecol Obstet 1991;173:303–308.
[PubMed]
15.
Tachibana M, Kinugasa S, Dhar DK, Tabara H, Masunaga R, Kotoh T, Kubota H, Nagasue N: Prognostic factors in T1 and T2 squamous cell carcinoma of the thoracic esophagus. Arch Surg 1999;134:50–54.
[PubMed]
16.
Killinger WA, Rice TW, Adelstein DJ, Medendorp SV, Zuccaro G, Kirby TJ, Goldblum JR: Stage II esophageal carcinoma: The significance of T and N. J Thorac Cardiovasc Surg 1996;111:935–940.
[PubMed]
17.
Skinner DB, Ferguson MK, Soriano A, Little AG, Staszak VM: Selection of operation for esophageal cancer based on staging. Ann Surg 1986;204:391–401.
[PubMed]
18.
Japanese Research Society for Gastric Cancer: The general rules for the gastric cancer study in surgery and pathology. Jpn J Surg 1981;11:127–139.
[PubMed]
19.
Abe S, Yoshimura H, Nagaoka S, Monden N, Kinugasa S, Nagasue N, Nakamura T: Long-term results of operation for carcinoma of the stomach in T1/T2 stages: Critical evaluation of the concept of early carcinoma of the stomach. J Am Coll Surg 1995;181:389–396.
[PubMed]
20.
Wang CS, Hsueh S, Chao TC, Jeng LB, Jan YY, Chen SC, Hwang TL, Chen PC, Chen MF: Prognostic study of gastric cancer without serosal invasion: Reevaluation of the definition of early gastric cancer. J Am Coll Surg 1997;185:496–480.
21.
Dukes CE, Bussey HJR: The spread of rectal cancer and its effect on prognosis. Br J Cancer 1958;12:309–320.
22.
Roder JD, Busch R, Stein HJ, Fink U, Siewert JR: Ratio of invaded to removed lymph nodes as a predictor of survival in squamous cell carcinoma of the oesophagus. Br J Surg 1994;81:410–413.
[PubMed]
23.
Hoelscher AH, Bollschweiler E, Bumm R, Bartels H, Hoefler H, Siewert JR: Prognostic factors of resected adenocarcinoma of the esophagus. Surgery 1995;118:845–855.
[PubMed]
© 2002 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2002
You do not currently have access to this content.
