Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for esophageal squamous cell carcinoma cancer underwent radical surgery

Publication date: Available online 23 June 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Derong Zhang, Yuzhen Zheng, Zhen Wang, Qingyuan Huang, Xun Cao, Feng Wang, Shuoyan Liu
BackgroundRecently, the 8^th edition of the TNM classification of esophageal cancer has come up. The present study aims to compare the 7^th and the proposed 8^th edition of the AJCC/UICC TNM staging system for esophageal squamous cell carcinoma (ESCC).MethodsA total of 1872 ESCC patients who underwent radical surgery with curative intent were analyzed retrospectively. Survival was analyzed using the Kaplan-Meier method, and values were compared using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model. The Akaike information criterion (AIC) and the concordance index (c-index) were applied to compare the two prognostic systems.ResultsOn univariate analysis, the 7^th staging system, the proposed 8^th staging system, gender, age as well as adjuvant treatment were found to have significant association with overall survival (OS). In both the current staging system and the modified version, age and gender were independent prognostic factors in a multivariate analysis. The AIC value for the proposed 8^th version was smaller than that for the 7^th staging system; the c-index value for the proposed 8^th version was larger than that for the 7^th staging system. Subgroup analysis in patients with/without nodal metastasis obtained consistent results.ConclusionBased on the data from our single center, the proposed 8^th AJCC staging system seems to be superior to the 7^th AJCC staging system in terms of OS for patients with thoracic ESCC who underwent radical surgery.



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