Table 3:
Association of Patient and Hospital Factors with Esophagectomy Margin Positivity
| Adjusted Odds Ratio (95% Confidence Interval) | p-value* | |
|---|---|---|
| Age | ||
| <55 | 1.00 | REF |
| 55–64 | 1.30 (0.97–1.75) | 0.078 |
| 65–74 | 1.38(1.00–1.90) | 0.048 |
| ≥75 | 2.04(1.42–2.92) | <0.001 |
| Race | ||
| White | 1.00 | REF |
| Black | 1.23 (0.79–1.92) | 0.360 |
| Hispanic | 1.25 (0.75–2.10) | 0.389 |
| Other | 1.07 (0.62–1.86) | 0.805 |
| Insurance Status | ||
| Medicaid/Medicare | 1.04 (0.82–1.31) | 0.750 |
| Private | 1.00 | REF |
| Other Government | 0.65 (0.30–1.44) | 0.289 |
| Uninsured | 1.05 (0.53–2.08) | 0.887 |
| Charlson-Deyo Index | ||
| 0 | 1.00 | REF |
| 1 | 0.90 (0.73–1.12) | 0.367 |
| 2 | 1.22 (0.84–1.78) | 0.293 |
| >3 | 1.84(1.08–3.12) | 0.024 |
| Median Zip Code Income | ||
| <38,000 | 1.00 | REF |
| 38,000–48,000 | 0.96 (0.72–1.28) | 0.785 |
| 48,000–63,000 | 0.95 (0.72–1.25) | 0.695 |
| >63,000 | 0.67 (0.50–0.91) | 0.009 |
| Quartile of Distance to Hospital (miles) | ||
| 1 (<1–7.3) | 1.00 | REF |
| 2(7.4–18.5) | 1.24 (0.94–1.63) | 0.130 |
| 3(18.6–49.8) | 1.41 (1.08–1.85) | 0.013 |
| 4 (>49.9) | 1.12(0.84–1.50) | 0.424 |
| Facility Type | ||
| Academic/Research | 1.00 | REF |
| Integrated Network Cancer Program | 1.32 (0.97–1.79) | 0.080 |
| Comprehensive Community Cancer Program | 0.98 (0.74–1.28) | 0.864 |
| Community Cancer Program | 0.97 (0.48–1.95) | 0.927 |
| Histologic Morphology | ||
| Adenocarcinoma | 1.00 | REF |
| Squamous Cell Carcinoma | 0.99 (0.75–1.31) | 0.964 |
| Carcinoma NOS | 0.65 (0.25–1.67) | 0.373 |
| Tumor Location | ||
| Upper Third | 2.07(1.16–3.68) | 0.014 |
| Middle Third | 1.13(0.83–1.54) | 0.444 |
| Lower Third | 1.00 | REF |
| Overlapping Sites/NOS | 1.40(1.05–1.86) | 0.023 |
| Clinical T Stage | ||
| Tis | 1.02 (0.50–2.11) | 0.948 |
| T1 | 1.00 | REF |
| T2 | 1.00 (0.74–1.35) | 0.993 |
| T3 | 1.70(1.24–2.33) | 0.001 |
| T4 | 3.42(1.89–6.17) | <0.001 |
| Clinical N Stage | ||
| NO | 1.00 | REF |
| N1 | 0.96 (0.76–1.22) | 0.758 |
| N2 | 0.73 (0.50–1.07) | 0.107 |
| N3 | 1.27 (0.71–2.28) | 0.422 |
| Tumor Grade | ||
| Well Differentiated | 1.00 | REF |
| Moderately Differentiated | 1.59(1.11–2.28) | 0.012 |
| Poorly Differentiated | 2.27(1.57–3.27) | <0.001 |
| Undifferentiated | 1.83 (0.84–4.00) | 0.130 |
| Tumor SizeJ | ||
| <2.0 | 1.00 | REF |
| 2.1–4.0 | 0.98 (0.77–1.25) | 0.881 |
| 4.1–6.0 | 1.01 (0.76–1.35) | 0.932 |
| >6.0 | 1.50(1.10–2.04) | 0.010 |
| Neoadjuvant Therapy | ||
| No | 1.00 | REF |
| Yes | 0.37 (0.29–0.47) | <0.001 |
| Surgical Approach | ||
| Open | 1.00 | REF |
| Laparoscopic | 1.70(1.40–2.06) | <0.001 |
| Robotic | 0.68 (0.44–1.06) | 0.086 |
| Mean Annual Hospital Esophagectomy Volume Quartile (n/year) | ||
| 1 (<2) | 1.00 | REF |
| 2 (2.1–5.4) | 0.90 (0.67–1.20) | 0.461 |
| 3(5.5–13.3) | 0.72 (0.52–1.00) | 0.049 |
| 4 (>13.3) | 0.70 (0.49–0.99) | 0.047 |
1 cm = centimeter