Comparision of the6th AJCC Staging System and the7th AJCC Staging System of Esophageal Carcinoma
|School||Beijing Union Medical College|
|Keywords||Esophageal neoplasms Prognosis Lymph nodes Cancer staging|
The objective and significance of malignant tumor TNM classification are prognosis prediction and guidance of making therapeutic scheme. It is also helpful to each treatment unit exchange acidity of information and comparison of effect. In the recent years, with diagnosis and treatment level to enhance unceasingly, esophageal carcinoma prognosis factors are constantly emerging change. So, esophageal carcinoma stage system is constantly revised and improved. The6th AJCC stage has been widely used for many years in the international. A lot of research had been verified superiority of the6th AJCC staging system, but its disadvantage has gradually appeared. So, UICC/AJCC pushed out a new esophageal carcinoma staging system--the7th AJCC stage in2009. So far, it had few research in the new esophageal carcinoma stage systems can make up disadvantage the6th AJCC staging system and better to guide therapeutic and prognosis prediction. We are necessary to compare two esophageal carcinoma stage systems in order to provide a reference for making and completing esophageal carcinoma staging system.Retrospectively analyzed the data of1397patients with esophageal carcinoma. Restaging was done according to the6th AJCC staging system and the7th AJCC staging system. Prognosis was compared by T-stage、N-stage and clinical-stage to provide suggestions for further ameliorate the esophageal carcinoma staging system. From January2003to December2009, all the biopsy-proven newly diagnosed esophageal carcinoma patients hospitalized to Cancer Hospital CAMS were collected. All patients were restaged according to the6th AJCC staging system and7th AJCC staging system based on the pretreatment medical records and imaging records. Prognosis was compared by T-stage、N-stage and clinical-stage according to2different staging systems. Statistical analysis were performed using the SPSS16.0software. All were estimated using Kaplan-Meier method, and the differences were compared using the Log-Rank test. The criterion for stasistical significance was set at P<0.05. The P values were based on2-sided tests.The5-year survival of the1397cases was38.5%。In terms of T stage, The5-year survival of the7th AJCC T1a, T1b was58%,39%, respectively. There was statistical significance in5years survival between them (P<0.05). The5years survival of7th AJCC N1, N2.N3were31.6%,17.9%, and16.1%, respectively. The5years survival was statistical significance between N1and N2and between N2and N3. According to the7th AJCC staging system, the5years survival of stage la, Ib and Ⅱa, Ⅱb were statistically significant (P<0.05).The newly refined esophageal cancer staging system redefines T, N, M, and added G. Using the new staging system, The differences in survival in the stages become more distinct. The7th edition AJCC TNM staging system is better able to stage the prognosis of esophageal carcinoma patients compared to its previous edition. Using this edition, the number of metastasized lymph nodes can be clearly estimated and this is significant for determining the correct prognosis.