Prognosis of patients with T2N0 tumors in the alimentary tract: should they be considered as early cancers?

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.