Original articleGeneral thoracicProposed Modification of Nodal Status in AJCC Esophageal Cancer Staging System
Section snippets
Patients
This study included 1,027 patients with histologically confirmed invasive squamous cell carcinoma or adenocarcinoma of the esophagus and gastroesophageal junction who had a minimum of four resected lymph nodes. There were 595 patients who received neoadjuvant therapy, and 432 were treated with surgery alone. All patients were resected with curative intent at the University of Texas M. D. Anderson Cancer Center (MDACC) between 1970 and 2005. Patients who did not survive longer than 30 days were
Patient and Survival Characteristics
The study population included all patients who had squamous cell carcinoma or adenocarcinoma treated from 1970 to 2005 who underwent esophageal resection at MDACC. Mean potential follow-up for the group was 145 months (range, 7.2 to 442). Demographics of the sample group are depicted in (Table 1). As expected for this group of North American patients, the vast majority were male with adenocarcinoma of the distal esophagus or gastroesophageal junction. Pathologic downstaging after neoadjuvant
Comment
The current AJCC esophageal cancer staging system is based on a T (tumor depth), N (regional nodal statues), and M (nonregional nodes or systemic metastases) staging classification [2]. Although the staging system currently in place is good at predicting long-term survival, as indicated by our data, modifications to the system results in more ordered differentiation of stages and eliminates some of the complicated features of the N and M portions of the TNM system. Revision of the esophageal
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