Comparison of the prognostic value of the seventh and eighth edition of The AJCC Esophageal Cancer Staging System for the patients with stage Ⅱ and Ⅲesophageal squamous cell carcinoma / 中华外科杂志

ABSTRACT

Objective@#To compare and evaluate the prognostic value of the 7th and 8th edition of The AJCC Esophageal Cancer Staging System for patients with stage Ⅱ and Ⅲ esophageal squamous cell carcinoma.@*Methods@#The clinical data of 328 esophageal cancer patients who received operation at Department of Esophageal Cancer, Tianjin Tumour Hospital from January 2006 to December 2010 were restrospectively analyzed. There were 63 female and 265 male patients. The mean age was 65 (range 33 to 87) years. Univariate and multivariate analysis were performed to identify the prognosis factors.@*Results@#The five years overall survival rates among patients with stage Ⅱ and Ⅲ were both significantly different (χ2=87.035, 84.730, all P=0.000) according to the 7th and 8th editions of the TNM staging systems. The five years overall survival rate among patients with stage ⅡB and ⅢA were significantly different (39.6% vs 23.4%, P=0.001) according to the 7th edition of the esophageal cancer staging systems.According to the 8th edition of the esophageal cancer staging system, the 5 years survival rate of patients with stage ⅡA and ⅡB, ⅢB and Ⅳ was statistically significant (58.5% vs. 35.5%, P=0.040; 18.9% vs. 0, P=0.000). In multivariate analysis, tumor size, T staging, N staging and tumor differentiation (HR=1.592, 95%CI 1.185 to 2.139, P=0.002; HR=1.519, 95% CI 1.236 to 1.867, P=0.000; HR=1.647, 95% CI 1.448 to 1.874, P=0.000; HR=1.404, 95% CI 1.059 to 1.861, P=0.018) were the main independent prognosis factors affecting the prognosis of esophageal squamous cell carcinoma patients.@*Conclusions@#Both the 7th and the 8th editions of TNM staging systems are able to reflect the clinical prognosis of patients receiving radical resection of esophageal cancer, and the factors of tumor size, differentiaton, invasion depth and lymph node metastases are the independent predictors of prognosis. The 8th edition provides a more detailed and more reasonable for the staging of stage Ⅱ and Ⅲ for esophageal cancer patients than the 7th edition, and it is more accurate for the prognosis of patients with esophageal cancer after surgery.