Increasing tumor length is associated with regional lymph node metastases and decreased survival in esophageal cancer

Background Although tumor length has received little attention for staging of esophageal cancer, it may be a valid prognostic feature for node positivity and survival. Methods Through retrospective review of a prospective institutional database, esophageal cancer patients who completed esophagectomy without neoadjuvant chemoradiation were analyzed. Pathologic tumor lengths were compared with node positivity and survival through a zero-inflated negative binomial regression model and multivariable Cox proportional hazards model, respectively. Results Between January 2000 and July 2015, 98 patients met inclusion, criteria (84% male, median age of 65, 90% adenocarcinoma). Median tumor length was 2.5 cm with each 1-cm increase in length increasing the odds of node positivity (odds ratio 3.55, 95% confidence interval 1.50 to 8.40, P =.004) and decreasing overall survival (hazards ratio 1.18, 95% confidence interval 1.06 to 1.32, P <.003). Conclusion This study suggests an association among tumor length, lymph node metastasis, as well as overall survival in esophageal cancer patients who have not received neoadjuvant chemoradiotherapy.