Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.
Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.
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DOI：
10.1111/dote.12540
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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;Blackstone EH;Hofstetter WL;Kelsen DP;Apperson-Hansen C;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连接部癌症临床分期组（cTNM）的建议。全球食管癌协作组（WECC）提供了22，123例临床分期的上皮性食管癌患者的数据。使用随机生存森林分析开发每例患者的风险调整生存期，其中（1）确定了数据驱动的临床分期组，其中生存期单调下降，组间差异明显，组内同质，（2）仅基于cTNM的数据驱动的解剖临床分期组。AJCC上消化道工作组通过平滑、简化、扩展和评估临床适用性，产生了（3）共识临床分期组。与pTNM相比，cTNM的生存率是“捏”的，早期cStage组的生存率较差，晚期cStage组的生存率较好。cT 2 N 0 M0鳞状细胞癌（SCC）和cT 1 - 2 N 0 M0腺癌的数据驱动分组的组织学分级是不同的，但共识将其删除。对于SCC，cN 0 -1对于cT 3而不是cT 1 -2是独特的，并且共识删除了cT 4亚分类，并添加了亚组0、IVA和IVB。对于腺癌，N 0 -1与cT 1 -2不同，而与cT 3 -4a不同，cStage II亚组是必要的（T1 N1 M0 [IIA]和T2 N 0 M0 [IIB]），晚期癌症cT 3 - 4aN 0 - 1 M0 + cT 2N 1 M0包含cStage III，共识增加了亚组0、IVA和IVB。治疗决策需要准确的cStage，这与pStage不同。分期过低和分期过高都是有问题的，在临床分期技术得到统一应用和改进之前，其他因素（如分级）可能有助于治疗决策和诊断。
We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was “pinched,” with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved.
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影响因子：
5.8
作者：
Stekhoven, Daniel J.;Buehlmann, Peter
通讯作者：
Buehlmann, Peter
影响因子：
2.1
作者：
Rice, Thomas W.;Blackstone, Eugene H.
通讯作者：
Blackstone, Eugene H.
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：
12.6
作者：
Davison, Jon M.;Landau, Michael S.;Nason, Katie S.
通讯作者：
Nason, Katie S.
DOI：
10.1111/dote.12493
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;Apperson-Hansen C;DiPaola LM;Semple ME;Lerut TE;Orringer MB;Chen LQ;Hofstetter WL;Smithers BM;Rusch VW;Wijnhoven BP;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;Blackstone EH
通讯作者：
Blackstone EH