Tumor Differentiation as a Prognostic Marker in Clinically Staged T1bN0 Esophageal Adenocarcinoma

Ofer Margalit*, Einat Shacham-Shmueli, Gal Strauss, Yu Xiao Yang, Yaacov R. Lawrence, Alon Ben Nun, Idan Levy, Kim A. Reiss, Talia Golan, Naama Halpern, Dan Aderka, Bruce Giantonio, Ronac Mamtani, Ben Boursi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Current guidelines recommend that clinically staged T1N0 esophageal cancers are to be referred to surgery or endoscopic resection. Using the National Cancer Database, we identified 733 individuals with clinically staged T1N0 esophageal carcinoma, who underwent upfront surgery and did not receive any prior treatment. We assessed upstaging, which was defined as ≥ T2 disease or positive lymph nodes. Poorly differentiated adenocarcinomas were associated with upstaging, whereas squamous cell carcinomas were not. Specifically, the percentage of upstaging among individuals with clinically staged T1b and poorly differentiated tumor was 33.8%. Therefore, clinically staged T1bN0 poorly differentiated esophageal adenocarcinomas are at high risk for upstaging following surgery.

Original languageEnglish
Pages (from-to)734-738
Number of pages5
JournalCancer Investigation
Issue number8
StatePublished - 2023


  • Esophageal adenocarcinoma
  • misclassification
  • prognostic marker
  • stage T1b
  • tumor differentiation


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