Comparison of the 6th and 7th Editions of the UICC-AJCC TNM Classification for Esophageal Cancer.
Comparison of the 6th and 7th Editions of the UICC-AJCC TNM Classification for Esophageal Cancer.
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DOI：
10.1245/s10434-012-2218-5
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发表时间：
2012-07
影响因子：
3.7
通讯作者：
Wijnhoven BP
中科院分区：
文献类型：
--
作者：
Talsma K;van Hagen P;Grotenhuis BA;Steyerberg EW;Tilanus HW;van Lanschot JJ;Wijnhoven BP
新的第7版国际癌症控制联盟-美国癌症联合委员会（UICC-AJCC）肿瘤，淋巴结，转移（TNM）分期系统是对全球食管癌协作数据库数据驱动建议的批准。单一机构的普遍性仍然值得怀疑。本研究是对第7版TNM系统在一个单一机构的以腺癌为主的前瞻性队列患者中的验证。纳入了1991年至2008年期间因食管或胃食管连接部浸润性癌而接受经裂孔食管切除术的患者。排除接受新辅助化疗（放疗）治疗的患者、非治愈性切除术后的患者和在医院死亡的患者。根据第6版和第7版UICC-AJCC分期系统对肿瘤进行分期。采用Kaplan-Meier法计算生存率，采用考克斯回归模型进行多因素分析。使用与考克斯回归模型相关的似然比卡方检验和赤池信息标准来测量拟合优度。确定了358例患者的研究人群。所有患者均因腺癌接受经裂孔食管切除术。5年生存率为38%。单因素分析显示pT分期、pN分期和pM分期显著预测总生存期。第7版的预测最好，对所有子阶段进行分层。与第6版相比，第7版UICC-AJCC分期系统的应用导致总生存期的更好预后分层。事实上，第七版主要在接受经裂孔手术方法的腺癌患者中表现更好，除了其他队列的早期研究结果外，支持其对不同食管癌实践的普遍性。
The new 7th edition of the Union for International Cancer Control–American Joint Committee on Cancer (UICC-AJCC) tumor, node, metastasis (TNM) staging system is the ratification of data-driven recommendations from the Worldwide Esophageal Cancer Collaboration database. Generalizability remains questionable for single institutions. The present study serves as a validation of the 7th edition of the TNM system in a prospective cohort of patients with predominantly adenocarcinomas from a single institution. Included were patients who underwent transhiatal esophagectomy with curative intent between 1991 and 2008 for invasive carcinoma of the esophagus or gastroesophageal junction. Excluded were patients who had received neoadjuvant chemo(radio)therapy, patients after a noncurative resection and patients who died in the hospital. Tumors were staged according to both the 6th and the 7th editions of the UICC-AJCC staging systems. Survival was calculated by the Kaplan–Meier method, and multivariate analysis was performed with a Cox regression model. The likelihood ratio chi-square test related to the Cox regression model and the Akaike information criterion were used for measuring goodness of fit. A study population of 358 patients was identified. All patients underwent transhiatal esophagectomy for adenocarcinoma. Overall 5-year survival rate was 38%. Univariate analysis revealed that pT stage, pN stage, and pM stage significantly predicted overall survival. Prediction was best for the 7th edition, stratifying for all substages. The application of the 7th UICC-AJCC staging system results in a better prognostic stratification of overall survival compared to the 6th edition. The fact that the 7th edition performs better predominantly in patients with adenocarcinomas who underwent a transhiatal surgical approach, in addition to findings from earlier research in other cohorts, supports its generalizability for different esophageal cancer practices.
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影响因子：
3.7
作者：
Thompson, Sarah K.;Ruszkiewicz, Andrew R.;Devitt, Peter G.
通讯作者：
Devitt, Peter G.
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：
9
作者：
Lerut, T;Nafteux, P;Ectors, N
通讯作者：
Ectors, N
影响因子：
4.6
作者：
Gaur, Puja;Hofstetter, Wayne L.;Swisher, Stephen G.
通讯作者：
Swisher, Stephen G.
影响因子：
6.4
作者：
KATO, H;TACHIMORI, Y;IIZUKA, T
通讯作者：
IIZUKA, T