Application of the proposed eighth edition of the American Joint Committee on Cancer/Union of International Cancer Control esophageal cancer staging system in esophageal cancer patients.

Objective: The eighth edition of the American Joint Committee on Cancer/Union of International Cancer Control esophageal cancer staging system was proposed in early 2018. The eighth edition staging system includes clinical staging, pathological staging, and neoadjuvant pathological staging, which fills in the blank of non‐operative staging of esophageal cancer. However, there are few reports on the eighth edition of clinical staging, and the purpose of the present study was to verify the prognostic value of the new American Joint Committee on Cancer clinical staging system for esophageal cancer patients who undergo radical radiation therapy. Methods: A total of 544 patients with esophageal cancer from Tianjin Medical University Cancer Institute and Hospital between March 2010 and September 2016 were staged according to the eighth American Joint Committee on Cancer clinical staging system. The Kaplan–Meier method was used to calculate the survival rate of the patients. The Cox regression model was used for multivariate prognostic analysis. Results: All the patients were divided into different groups by the eighth American Joint Committee on Cancer clinical tumor–node–metastasis staging system: 40 patients with T2; 157 patients with T3; 347 patients with T4; 132 patients with N0; 193 patients with N1; 172 patients with N2; 47 patients with N3; 81 patients with stage II; 102 patients with state III; and 361 patients with stage IVA. The 3‐year survival rates of stage T2, stage T3, and stage T4 were 60.1%, 45.6%, and 30.8%, respectively (P < 0.001). The 3‐year survival rates of stage N0, stage N1, stage N2, and stage N3 were 48.2%, 40.7%, 29.4%, and 17.3%, respectively (P < 0.001). The 3‐year survival rates of stage II, stage III, and stage IVA were 59.3%, 40.1%, and 31.2%, respectively (P < 0.001). In univariate analysis, age, concurrent chemoradiotherapy, T stage, N stage, Karnofsky marking system, the sixth edition staging system and the eighth edition staging system were important prognostic factors in univariate analyses. In multivariate analysis, concurrent chemotherapy and N stage were important prognostic factors. Conclusions: Based on the data from Tianjin Medical University Cancer Institute and Hospital, the eighth edition clinical staging system had a better predictive ability for esophageal cancer patients who underwent radical radiation therapy. [ABSTRACT FROM AUTHOR]