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The revised American Joint Committee on Cancer staging system (7th edition) improves prognostic stratification after minimally invasive esophagectomy for esophagogastric adenocarcinoma
- Source :
- American journal of surgery. 210(4)
- Publication Year :
- 2015
-
Abstract
- Staging for esophagogastric adenocarcinoma lacked sufficient prognostic accuracy and was revised. We compared survival prognostication between American Joint Committee on Cancer (AJCC) 6th and 7th editions.We abstracted data for 836 patients who underwent minimally invasive esophagectomy for esophagogastric adenocarcinoma (n = 256 neoadjuvant). Monotonicity and strength of survival trends, by stage, were assessed (log-rank test of trend chi-square statistic) and compared using permutation testing. Overall survival (Cox regression) and model fit (Akaike Information Criterion) were determined.A greater log-rank test of trend statistic indicated stronger survival trends by stage in AJCC 7th (152.872 vs 167.623; permutation test P.001) edition. Greater Cox likelihood chi-square value (162.957 vs 173.951) and lower Akaike Information Criterion (4,831.011 vs 4,820.016) indicated better model fit. Superior performance was also shown after neoadjuvant therapy.AJCC 7th edition staging for esophagogastric adenocarcinoma provides superior prognostic stratification after minimally invasive esophagectomy, overall and after neoadjuvant therapy compared with AJCC 6th edition.
- Subjects :
- Male
medicine.medical_specialty
Esophageal Neoplasms
medicine.medical_treatment
Adenocarcinoma
Prognostic stratification
Article
Cohort Studies
Predictive Value of Tests
Invasive esophagectomy
medicine
Humans
Stage (cooking)
Neoadjuvant therapy
Cancer staging
Aged
Neoplasm Staging
Proportional hazards model
business.industry
General surgery
General Medicine
Middle Aged
medicine.disease
Prognosis
Neoadjuvant Therapy
United States
Esophagectomy
Survival Rate
Surgery
Female
Laparoscopy
Radiology
Esophagogastric Junction
business
Subjects
Details
- ISSN :
- 18791883
- Volume :
- 210
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- American journal of surgery
- Accession number :
- edsair.doi.dedup.....ce8800db6955ea11b5965ea6140522aa