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Evaluation of the 7th edition of the TNM classification in patients with resected esophageal squamous cell carcinoma.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2014 Dec 28; Vol. 20 (48), pp. 18397-403. - Publication Year :
- 2014
-
Abstract
- Aim: To evaluate the prognostic factors and tumor stages of the 7(th) edition TNM classification for esophageal cancer.<br />Methods: In total, 1033 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgical resection with or without (neo)adjuvant therapy between January 2003 and June 2012 at the Thoracic Surgery Department II of the Beijing Cancer Hospital, Beijing, China were included in this study. The following eligibility criteria were applied: (1) squamous cell carcinoma of the esophagus or gastroesophageal junction identified by histopathological examination; (2) treatment with esophagectomy plus lymphadenectomy with curative intent; and (3) complete pathologic reports and follow-up data. Patients who underwent non-curative (R1) resection and patients who died in hospital were excluded. Patients who received (neo)adjuvant therapy were also included in this analysis. All patients were restaged using the 7(th) edition of the Union for International Cancer Control and the American Joint Committee on Cancer TNM staging systems. Univariate and multivariate analyses were performed to identify the prognostic factors for survival. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate differences between the subgroups.<br />Results: Of the 1033 patients, 273 patients received (neo)adjuvant therapy, and 760 patients were treated with surgery alone. The median follow-up time was 51.6 mo (range: 5-112 mo) and the overall 5-year survival rate was 36.4%. Gender, "pT" and "pN" descriptors, (neo)adjuvant therapy, and the 7(th) edition TNM stage grouping were independent prognostic factors in the univariate and multivariate analyses. However, neither histologic grade nor cancer location were independent prognostic factors in the univariate and multivariate analyses. The 5-year stage-based survival rates were as follows: IA, 84.9%; IB, 70.9%; IIA, 56.2%; IIB, 43.3%; IIIA, 37.9%; IIIB, 23.3%; IIIC,12.9% and IV, 3.4%. There were significant differences between each adjacent staging classification. Moreover, there were significant differences between each adjacent pN and pM subgroup. According to the pT descriptor, there were significant differences between each adjacent subgroup except between pT3 and pT4 (P = 0.405). However, there was no significant difference between each adjacent histologic grade subgroup and between each adjacent cancer location subgroup.<br />Conclusion: The 7(th) edition is considered to be valid for patients with resected ESCC. However, the histologic grade and cancer location were not prognostic factors for ESCC.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell mortality
Esophageal Neoplasms mortality
Esophageal Squamous Cell Carcinoma
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Neoadjuvant Therapy
Neoplasm Grading
Predictive Value of Tests
Proportional Hazards Models
Reproducibility of Results
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
Carcinoma, Squamous Cell pathology
Carcinoma, Squamous Cell surgery
Esophageal Neoplasms pathology
Esophageal Neoplasms surgery
Esophagectomy
Neoplasm Staging methods
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 20
- Issue :
- 48
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 25561808
- Full Text :
- https://doi.org/10.3748/wjg.v20.i48.18397