Application of the Eighth AJCC TNM Staging System in Patients With Esophageal Squamous Cell Carcinoma
Application of the Eighth AJCC TNM Staging System in Patients With Esophageal Squamous Cell Carcinoma
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DOI：
10.1016/j.athoracsur.2017.12.032
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发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Wu, Shiao-Chi
中科院分区：
文献类型：
--
作者：
Hsu, Po-Kuei;Chen, Hui-Shan;Wu, Shiao-Chi
背景第八版美国癌症联合委员会肿瘤-淋巴结-转移分期系统将临床（c）、病理（p）和新辅助治疗后病理（yp）分期分开。我们的目的是评估其在食管鳞状细胞癌（ESCC）患者中的应用。患者数据来自台湾癌症登记数据库。生存分析包括因I期至III期食管鳞癌行食管切除术的患者。分别纳入3，399、1，805和1，594例患者的数据进行c、p和yp分期。c期I、II和III的3年总生存率（OS）分别为67.4%、46.7%和38.4%。p I、II、III和IV期的3年OS率分别为70.7%、49.8%、30.8%和10.6%。yp I、II、III和IV期的3年OS率分别为59.4%、37.8%、27.6%和3.7%。生存曲线分析表明，一个强大的歧视能力和单调性的梯度的新系统。然而，在具有实质性生存差异的异质性患者组中观察到yp I期。同时，ypT 0 N 0期患者的5年OS率为52.1%，与p I期患者（54.5%）相当。ypTis-2 N 0患者的5年OS率为39.1%，与p II期患者（40.1%）相当。结论。本研究作为一个外部验证的新发布的分期系统在ESCC患者的分类，并建议在未来的亚组的yp阶段I到ypT 0 N 0和non-ypT 0 N 0。(C)2018胸外科医师协会
Background. The eighth edition of the American Joint Committee on Cancer Tumor-Node-Metastasis staging system separates classifications for the clinical (c), pathologic (p), and postneoadjuvant pathologic (yp) stages. We aimed to evaluate its application in patients with esophageal squamous cell carcinoma (ESCC).Methods. Patient data were obtained from the Taiwan Cancer Registry database. Patients who underwent esophagectomy for c stage I to III ESCC were included for survival analysis.Results. Data of 3,399, 1,805, and 1,594 patients were included for c, p, and yp staging, respectively. The 3-year overall survival (OS) rates for c stage I, II, and III were 67.4%, 46.7%, and 38.4%, respectively. The 3-year OS rates for p stage I, II, III, and IV were 70.7%, 49.8%, 30.8%, and 10.6%, respectively. The 3-year OS rates for yp stage I, II, III, and IV were 59.4%, 37.8%, 27.6%, and 3.7%, respectively. Survival curve analysis demonstrated a robust discriminatory capability and monotonicity of gradients of the new system. However, yp stage I was observed in a heterogeneous group of patients with substantial survival differences. Meanwhile, patients in the ypT0 N0 stage had a 5-year OS rate of 52.1%, which was equivalent to that of patients with p stage I (54.5%). The 5-year OS rate of patients in the ypTis-2N0 was 39.1%, which was equivalent to that of patients in p stage II (40.1%).Conclusions. The present study serves as an external validation of the newly released staging system in the prognostication of patients with ESCC and suggests subgrouping of the yp stage I into ypT0 N0 and non-ypT0 N0 in the future. (C) 2018 by The Society of Thoracic Surgeons