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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2014

01-01-2014 | Thoracic Oncology

Proposed Modification of the Seventh American Joint Committee on Cancer Staging System for Esophageal Squamous Cell Carcinoma in Chinese Patients

Authors: Xue Hou, MD, Jin-Chang Wei, MD, Jian-Hua Fu, MD, Xin Wang, MD, Lan-Jun Zhang, MD, Peng Lin, MD, Hao-Xian Yang, MD

Published in: Annals of Surgical Oncology | Issue 1/2014

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Abstract

Background

More data are essential to test the efficacy of the American Joint Committee on Cancer (AJCC) system for staging esophageal squamous cell carcinoma (ESCC). On the basis of previous studies, we propose a modification to this system to better represent the survival characteristics of ESCC in the Chinese population.

Methods

We used data from two centers to establish the generating (n = 1006) and validation (n = 783) cohorts. All of the patients underwent curative surgical treatment. On the basis of previous studies, we excluded tumor location as a variable in the modified pathological staging system and defined the modified nodal categories as follows: N0, node negative; N1, 1 positive node; N2, 2 to 3 positive nodes; and N3, >3 positive nodes. The pathological T categories, pathological M categories, and cell differentiation in the seventh AJCC staging system for adenocarcinoma were used in the modified pathological staging system for ESCC.

Results

The median survival times for ESCC patients with stage 0 and Ia, stage Ib, stage IIa, stage IIb, stage IIIa, stage IIIb, stage IIIc were as follows: not reached, 221.2, 151.8, 88.5, 25.0, 19.0, and 13.0 months, respectively, for the entire cohort of patients (n = 1789). The corresponding 5-year survival rates were 86.7, 76.4, 64.9, 55.3, 29.9, 16.9, and 9.7 %, respectively. The survival rates significantly differed between the modified staging groups (p < 0.01).

Conclusions

This modified staging system better discriminates the survival differences between stages than the seventh edition of the AJCC staging system for ESCC in Chinese patients.
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Metadata
Title
Proposed Modification of the Seventh American Joint Committee on Cancer Staging System for Esophageal Squamous Cell Carcinoma in Chinese Patients
Authors
Xue Hou, MD
Jin-Chang Wei, MD
Jian-Hua Fu, MD
Xin Wang, MD
Lan-Jun Zhang, MD
Peng Lin, MD
Hao-Xian Yang, MD
Publication date
01-01-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3265-2

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