NDLI: Evaluation of the $7^{th}$ edition of the UICC-AJCC tumor, node, metastasis classification for esophageal cancer in a Chinese cohort

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Huang, Yan Guo, Weigang Shi, Shiming He, Jian
Description	Country affiliation: China Author Affiliation: Huang Y ( Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.); Guo W ( Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.); Shi S ( Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.); He J ( Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.)
Abstract	BACKGROUND: To assess and evaluate the prognostic value of the 7(th) edition of the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC) tumor, node, metastasis (TNM) staging system for Chinese patients with esophageal cancer in comparison with the 6(th) edition. METHODS: A retrospective review was performed on 766 consecutive esophageal cancer patients treated with esophagectomy between 2008 and 2012. Patients were staged according to the 6(th) and 7(th) editions for esophageal cancer respectively. Survival was calculated by the Kaplan-Meier method, and multivariate analysis was performed using Cox regression model. RESULTS: Overall 3-year survival rate was 59.5%. There were significant differences in 3-year survival rates among T stages both according to the 6(th) edition and the 7(th) edition (P<0.001). According to the 7(th) edition, the 3-year survival rates of N0 (75.4%), N1 (65.2%), N2 (39.7%) and N3 (27.3%) patients were significant differences (P<0.001). Kaplan-Meier curve revealed a good discriminatory ability from stage I to IV, except for stage IB, IIA and IIB in the 7(th) edition staging system. Based on the 7(th) edition, the degree of differentiation, tumor length and tumor location were not independent prognostic factors on multivariate analysis. The multivariate analyses suggested that pT-, pN-, pTNM-category were all the independent prognostic factors based on the 6(th) and 7(th) edition staging system. CONCLUSIONS: The 7(th) edition of AJCC TNM staging system of esophageal cancer should discriminate pT2-3N0M0 (stage IB, IIA and IIB) better when considering the esophageal squamous cell cancer patients. Therefore, to improve and optimize the AJCC TNM classification for Chinese patients with esophageal cancer, more considerations about the value of tumor grade and tumor location in pT2-3N0M0 esophageal squamous cell cancer should be taken in the next new TNM staging system.
File Format	HTM / HTML
ISSN	20721439
e-ISSN	20776624
DOI	10.21037/jtd.2016.06.24
Journal	Journal of Thoracic Diseases
Issue Number	7
Volume Number	8
Language	English
Publisher	AME Publishing Company
Publisher Date	2016-07-01
Publisher Place	China
Access Restriction	Open
Subject Keyword	Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine

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