Esophagus or Stomach? The Seventh TNM Classification for Siewert Type II/III Junctional Adenocarcinoma
Esophagus or Stomach? The Seventh TNM Classification for Siewert Type II/III Junctional Adenocarcinoma
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DOI：
10.1245/s10434-012-2780-x
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发表时间：
2013-03-01
影响因子：
3.7
通讯作者：
Tsuburaya, Akira
中科院分区：
文献类型：
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作者：
Hasegawa, Shinichi;Yoshikawa, Takaki;Tsuburaya, Akira
本研究的目的是阐明TNM-EC或TNM-GC是否更好地用于AEG II/III型患者的分类。选择AEG II/III型并接受D1或以上根治性淋巴结切除术的患者。患者均采用第七版TNM-EC和TNM-GC分期。比较患者的分布、各阶段的风险比（HR）以及生存期的分离情况。TNM-EC和TNM-GC分类25（20和5）和32（20和12）例患者进入I期（A和B），15（4和11）和33（11和22）至II期（IIA和IIB），88例（24、3和61）和63例（14、26和23）至III期（IIIA、IIIB和IIIC），35例和35例至IV期。患者的分布在TNM-EC中基本上偏离到IIIC期，而在TNM-GC中几乎均匀。在TNM-GC中观察到HR的逐步增加，而在TNM-EC中未观察到。Ⅱ期和Ⅲ期生存曲线在TNM-GC中显著分离（P = 0.019），而在TNM-EC中无分离（P = 0.204）。在TNM-EC中，IIIA、IIIB和IIIC期的5年生存率分别为69.0%、100%和38.9%，而在TNM-GC中分别为52.0%、43.4%和33.9%。这些结果可能会影响AEG的下一次TNM修订。
The aim of this study is to clarify whether TNM-EC or TNM-GC is better for classifying patients with AEG types II/III.The patients who had AEG types II/III and received D1 or more radical lymphadenectomy were selected. The patients were staged both by seventh edition of TNM-EC and TNM-GC. The distribution of the patients, the hazard ratio (HR) of each stage, and the separation of the survival were compared.A total of 163 patients were enrolled in this study. TNM-EC and TNM-GC classified 25 (20 and 5) and 32 (20 and 12) patients to stage I (IA and IB), 15 (4 and 11), and 33 (11 and 22) to stage II (IIA and IIB), 88 (24, 3, and 61) and 63 (14, 26, and 23) to stage III (IIIA, IIIB, and IIIC), and 35 and 35 to stage IV, respectively. The distribution of the patients was substantially deviated to stage IIIC in TNM-EC but was almost even in TNM-GC. A stepwise increase of HR was observed in TNM-GC, but not in TNM-EC. The survival curves between stages II and III were significantly separated in TNM-GC (P = 0.019), but not in TNM-EC (P = 0.204). The 5-year survival rates of stages IIIA, IIIB, and IIIC were 69.0, 100, and 38.9 % in TNM-EC and were 52.0, 43.4, and 33.9 % in TNM-GC, respectively.TNM-GC is better for classifying patients with AEG types II/III than TNM-EC is. These results could impact the next TNM revision for AEG.