Recommendations for pathologic staging (pTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.
Recommendations for pathologic staging (pTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.
复制标题
DOI：
10.1111/dote.12533
复制
发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Worldwide Esophageal Cancer Collaboration Investigators
中科院分区：
文献类型：
--
作者：
Rice TW;Ishwaran H;Hofstetter WL;Kelsen DP;Apperson-Hansen C;Blackstone EH;Worldwide Esophageal Cancer Collaboration Investigators
我们报告了分析和共识过程，为AJCC/UICC癌症分期手册（第8版）提供了食管和食管胃结合部癌症病理分期组（pTNM）的建议。全球食管癌协作组提供了22，654例上皮性食管癌患者的数据; 13，300例术前未接受治疗的患者在食管切除术或内镜治疗后进行了病理评估。使用随机生存森林分析开发每例患者的风险调整生存期，以确定数据驱动的病理分期组，其中生存期随组的增加而单调下降，组间有区别，组内同质。AJCC上消化道工作组，通过平滑，简化，扩展和评估临床适用性，产生共识病理分期组。对于pT 1 - 3 N 0 M0鳞状细胞癌（SCC）和pT 1 - 2N 0 M0腺癌，pT不足以进行分组;对pT 1进行亚分类并增加组织学分级可增强分期;癌症位置可改善SCC分期。pT 2N 0 M0和pT 3 N 0 M0 G1 SCC组的一致排除位置，尽管生存率相似，但将0期限制为pTis，不包括pT 1aN 0 M0 G1。转移显著降低生存率; pT、pN和pM足以将晚期癌症分组。IIA期和IIB期SCC和腺癌的组成不同，但生存率相似。共识IV期亚组承认pT 4 N+和pN 3癌症的生存率很低，与pM 1相似。仅基于pTNM的解剖病理分期分组，以早期组的同质性为代价，产生了相同的SCC和腺癌共识分期组。病理分期既不能指导治疗前的决定，也不能帮助确定除食管切除术或内镜治疗以外的治疗。然而，它为食管癌提供了一个干净的单一治疗参考点。
We report analytic and consensus processes that produced recommendations for pathologic stage groups (pTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 13,300 without preoperative therapy had pathologic assessment after esophagectomy or endoscopic treatment. Risk-adjusted survival for each patient was developed using random survival forest analysis to identify data-driven pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus pathologic stage groups. For pT1-3N0M0 squamous cell carcinoma (SCC) and pT1-2N0M0 adenocarcinoma, pT was inadequate for grouping; subcategorizing pT1 and adding histologic grade enhanced staging; cancer location improved SCC staging. Consensus eliminated location for pT2N0M0 and pT3N0M0G1 SCC groups, and despite similar survival, restricted stage 0 to pTis, excluding pT1aN0M0G1. Metastases markedly reduced survival; pT, pN, and pM sufficiently grouped advanced cancers. Stage IIA and IIB had different compositions for SCC and adenocarcinoma, but similar survival. Consensus stage IV subgrouping acknowledged pT4N+ and pN3 cancers had poor survival, similar to pM1. Anatomic pathologic stage grouping, based on pTNM only, produced identical consensus stage groups for SCC and adenocarcinoma at the cost of homogeneity in early groups. Pathologic staging can neither direct pre-treatment decisions nor aid in prognostication for treatment other than esophagectomy or endoscopic therapy. However, it provides a clean, single therapy reference point for esophageal cancer.
登录
查看更多内容
影响因子：
4.6
作者：
Hsu, Po-Kuei;Wu, Yu-Chung;Hsu, Wen-Hu
通讯作者：
Hsu, Wen-Hu
影响因子：
3.7
作者：
Situ, Dongrong;Wei, Weidong;Ma, Guowei
通讯作者：
Ma, Guowei
影响因子：
5.8
作者：
Stekhoven, Daniel J.;Buehlmann, Peter
通讯作者：
Buehlmann, Peter
影响因子：
3.7
作者：
Talsma K;van Hagen P;Grotenhuis BA;Steyerberg EW;Tilanus HW;van Lanschot JJ;Wijnhoven BP
通讯作者：
Wijnhoven BP
DOI：
10.1111/dote.12513
发表时间：
2016-10
期刊：
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
影响因子：
--
作者：
Rice TW;Lerut TE;Orringer MB;Chen LQ;Hofstetter WL;Smithers BM;Rusch VW;van Lanschot J;Chen KN;Davies AR;D'Journo XB;Kesler KA;Luketich JD;Ferguson MK;Räsänen JV;van Hillegersberg R;Fang W;Durand L;Allum WH;Cecconello I;Cerfolio RJ;Pera M;Griffin SM;Burger R;Liu JF;Allen MS;Law S;Watson TJ;Darling GE;Scott WJ;Duranceau A;Denlinger CE;Schipper PH;Ishwaran H;Apperson-Hansen C;DiPaola LM;Semple ME;Blackstone EH
通讯作者：
Blackstone EH