Worldwide Esophageal Cancer Collaboration: neoadjuvant pathologic staging data.
Worldwide Esophageal Cancer Collaboration: neoadjuvant pathologic staging data.
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DOI：
10.1111/dote.12513
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Blackstone EH
中科院分区：
文献类型：
--
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
为了解决食管癌新辅助治疗（ypTNM）后的病理分期分组是否与单独食管切除术（pTNM）后的病理分期具有共同的预后影响的不确定性，我们报告了全球食管癌合作组织（WECC）新辅助治疗后的病理分期数据——患者特征、癌症类别和非风险调整生存期的简单描述。来自六大洲的 33 个机构使用具有标准定义的变量提交了数据：人口统计、合并症、临床癌症类别以及首次管理决策的全因死亡率。在 7,773 例病理分期新辅助患者中，2,045 例为鳞状细胞癌，5,686 例为腺癌，31 例为腺鳞癌，11 例为未分化癌。患者为年龄较大（61岁）的男性（83%），体重指数正常（40%）或超重（35%），表现状态为0-1东部肿瘤合作组（96%），有吸烟史（69%）。癌症为 ypT0 (20%)、ypT1 (13%)、ypT2 (18%)、ypT3 (44%)、ypN0 (55%)、ypM0 (94%) 和 G2-G3 (72%)；大多数累及远端食管（80%）。与先前 WECC 数据中仅接受食管切除术的患者的同等类别相比，yp 类别的非风险调整生存率的下降程度不同，早期类别的生存率高于晚期类别。因此，无论 ypT 为何，ypT0-2N0M0 癌症患者的生存率处于中等水平且相似； ypN+ 癌症的生存率很差。由于 ypTNM 和 pTNM 类别的预后不同，因此预测应基于单独的 ypTNM 类别和分组。这些数据将成为第八版癌症分期手册的基础，根据患者、癌症和治疗特征进行风险调整，并应指导第九版数据收集。
To address uncertainty of whether pathologic stage groupings after neoadjuvant therapy (ypTNM) for esophageal cancer share prognostic implications with pathologic groupings after esophagectomy alone (pTNM), we report data—simple descriptions of patient characteristics, cancer categories, and non–risk-adjusted survival—for pathologically staged cancers after neoadjuvant therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted data using variables with standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 7,773 pathologically staged neoadjuvant patients, 2,045 had squamous cell carcinoma, 5,686 adenocarcinoma, 31 adenosquamous carcinoma, and 11 undifferentiated carcinoma. Patients were older (61 years) men (83%) with normal (40%) or overweight (35%) body mass index, 0–1 Eastern Cooperative Oncology Group performance status (96%), and a history of smoking (69%). Cancers were ypT0 (20%), ypT1 (13%), ypT2 (18%), ypT3 (44%), ypN0 (55%), ypM0 (94%), and G2-G3 (72%); most involved the distal esophagus (80%). Non–risk-adjusted survival for yp categories was unequally depressed, more for earlier categories than later, compared with equivalent categories from prior WECC data for esophagectomy-alone patients. Thus, survival of patients with ypT0-2N0M0 cancers was intermediate and similar regardless of ypT; survival for ypN+ cancers was poor. Because prognoses for ypTNM and pTNM categories are dissimilar, prognostication should be based on separate ypTNM categories and groupings. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient, cancer, and treatment characteristics and should direct 9th edition data collection.
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影响因子：
3.7
作者：
BLACKSTONE, EH;NAFTEL, DC;TURNER, ME
通讯作者：
TURNER, ME
影响因子：
2.9
作者：
van Leeuwen, Pim J.;Kranse, Ries;Schroder, Fritz H.
通讯作者：
Schroder, Fritz H.
影响因子：
1.8
作者：
GOLDMAN, AI
通讯作者：
GOLDMAN, AI
影响因子：
10.3
作者：
Black, WC;Haggstrom, DA;Welch, HG
通讯作者：
Welch, HG
影响因子：
6.2
作者：
Rice, Thomas W.;Rusch, Valerie W.;Blackstone, Eugene H.
通讯作者：
Blackstone, Eugene H.