O64 META-ANALYSIS OF PROGNOSTIC FACTORS FOR OVERALL SURVIVAL IN PATIENTS UNDERGOING OESOPHAGECTOMY FOR OESOPHAGEAL CANCERS. (23rd November 2019)

• Record Type: Journal Article
• Authors: Kamarajah, Sivesh K; Marson, Ella J; Zhou, Dengyi; Wyn-Griffiths, Freddie; Richard P T, Evans; Bundred, James R; Singh, Pritam; Griffiths, Ewen A
• Is Part Of: Diseases of the esophagus. Volume 32(2019)Supplement 2
• Publication Date: 2019-11-23
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doz092.64
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: Aims: The objective of this meta-analysis was to assess statistically the impact of patient-level, operative, and tumour characteristics on overall survival of patients undergoing curative resection for oesophageal cancer. Introduction: Oesophageal cancer is staged using the American Joint Comission on Cancer (AJCC) staging system. Numerous other prognostically important histopathological and demographic characteristics have been reported. Methods: This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 31 st December 2018. A meta-analysis was conducted with the use of random-effects modelling to determine pooled univariable hazard ratios (HRs) and prospectively registered with the PROSPERO database (Registration CRD42018130732). Results: One-hundred and sixty-six articles including 70, 299 patients were assessed quantitatively. Of the 122 factors associated with survival, 39 were significant on pooled analysis. Of these the strongly associated prognostic factors were T stage (HR: 2.07, CI95% : 1.77 - 2.43, p<0.001), N stage (HR: 2.24, CI95% : 1.95 - 2.59, p<0.001), perineural invasion (HR: 1.54, CI95% : 1.36 - 1.74, p<0.001), circumferential resection margin (HR: 2.17, CI95% : 1.82 - 2.59, p<0.001), poor tumour grade (HR: 1.53, CI95% : 1.34 - 1.74, p<0.001), and high neutrophil:lymphocyte ratio (HR: 1.47, CI95% : 1.30 - 1.66, p<0.001). Conclusion: Several tumour biological variables not included in the AJCC 8 th edition classification can impact on overall survival. These require incorporation into prognostic models to ensure a personalised approach to prognostication and treatment.