scholarly journals Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study

2020 ◽  
Vol 9 (13) ◽  
pp. 4648-4655
Author(s):  
Yonggang Yuan ◽  
Ge Ma ◽  
Xuelei Hu ◽  
Qingyuan Huang
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System ◽  
Eighth Edition

RA10.06: THE ROLE AND PROGNOSTIC SIGNIFICANCE OF AORTOPULMONARY, ANTERIOR MEDIASTINAL, AND TRACHEOBRONCHIAL LYMPH NODES IN ESOPHAGEAL CANCER: UPDATE OF THE 2018 TNM STAGING SYSTEM

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 43-44
Author(s):  
Wen-Ping Wang ◽  
Yu-Shang Yang ◽  
Song-Lin He ◽  
Wei-Peng Hu ◽  
Long-Qi Chen
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Regional Lymph Node ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Therapeutic Value ◽  
Tnm Staging System ◽  
N Stage ◽  
Eighth Edition

Abstract Background The eighth edition of the American Joint Committee on Cancer TNM staging for esophageal cancer will be implemented at the beginning of 2018. The nodal staging process in the eighth edition remains unchanged from that in the seventh edition in that it was based on the number of lymph nodes (LNs) involved, but the regional lymph node map has been revised. The aortopulmonary (station 5), anterior mediastinal (station 6), and tracheobronchial (station 10) nodes have been omitted from the regional lymph node map for the new TNM staging. However, the role and prognostic significance of these LN stations are not clear. The purpose of this study was to investigate whether the revised nodal staging used in the eighth edition staging system is appropriate, and to verify the role, prognostic significance, and therapeutic value of these LNs in esophageal cancer. Methods The records of patients who underwent esophagectomy for cancer in our department between January 2007 and January 2013 were retrospectively analyzed. The rate of metastases and the index of estimated benefit from lymph node dissection (IEBLD) were calculated for stations 5, 6, and 10 LNs. LN metastasis and patient survival were analyzed and the efficacy of the eighth edition TNM staging system was verified. Results A total of 1637 patients (1350 men, 287 women) were included. The frequencies of dissection of stations 5, 6, and 10 LNs were 34.3% (562/1637), 15.9% (260/1637), and 50.9% (833/1637), respectively. The calculated rate of metastasis to these stations was 3.2% (18/562), 2.3% (6/260), and 4.9% (41/833), respectively. No difference was found in the N stage determined by the seventh and eighth edition N staging systems. The survival curves differed significantly between N stages calculated using the eighth edition TNM system (P < 0.001). The IEBLD values of stations 5, 6, and 10 LNs were 0.57, 0, and 0.97, respectively. Station 5 or 10 LN(+ ) patients had worse median survival time and 5-year overall survival rate compared with LN(–) patients (P < 0.01). Univariate analysis showed that differentiation, T stage, N stage (both seventh and eighth edition calculations), and metastasis to stations 5 and 10 LNs were associated with long-term survival. Conclusion Metastasis to stations 5, 6, or 10 LNs was infrequent. If stations 5, 6, and 10 LNs were omitted in the eighth edition calculation to determine the N stage based on the number of metastatic LNs, this did not influence the accuracy and survival-predicting efficacy of the eighth edition TNM staging. The therapeutic value of lymphadenectomy of stations 5, 6, and 10 was limited. Metastasis to stations 5, 6, and 10 LNs indicated more advanced N stage, which was associated with poor survival. However, no survival difference was found between station 6 LN(+ ) and LN(–) subgroups, possibly because of the limited numbers of cases. Disclosure All authors have declared no conflicts of interest.

Does the TNM Staging System for Esophageal Cancer Need Revision?

2006 ◽  
Vol 202 (5) ◽  
pp. 855-856 ◽  
Author(s):  
C.S. Pramesh ◽  
Rajesh C. Mistry ◽  
Nirmala A. Jambhekar ◽  
Sarbani G. Laskar
Keyword(s):  
Esophageal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System

New and Important Changes in the TNM Staging System for Breast Cancer

2018 ◽  
pp. 457-467 ◽  
Author(s):  
Gabriel N. Hortobagyi ◽  
Stephen B. Edge ◽  
Armando Giuliano
Keyword(s):  
Breast Cancer ◽  
Regional Lymph Node ◽  
Staging System ◽  
Distant Metastases ◽  
Tnm Staging ◽  
Pathology Report ◽  
Imaging Evaluation ◽  
Complete Surgical Excision ◽  
Tnm Staging System ◽  
Eighth Edition

Expanded understanding of biologic factors that modulate the clinical course of malignant disease have led to the gradual integration of biomarkers into staging classifications. The American Joint Committee on Cancer (AJCC) TNM staging system is universally used and has largely displaced other staging classifications for most, although not all, cancers. Many of the chapters of the eighth edition of the AJCC TNM staging system integrated biomarkers with anatomic definitions. The Breast Chapter added estrogen receptor (ER) and progesterone receptor (PR) expression, HER2 expression, and/or amplification and histologic grade to the anatomic assessment of tumor size, regional lymph node involvement, and distant metastases (known as TNM). While preserving an anatomic staging system for continuity and for regions where modern biomarkers are not always available, the eighth edition emphasizes the increased prognostic precision of the clinical prognostic stage groups and the pathologic prognostic stage groups. The clinical prognostic stage groups are applicable to all patients with primary breast cancer before any treatment has been implemented, but require a clinical and imaging evaluation as well as a biopsy with grade and available ER, PR, and HER2 results; the pathologic prognostic stage groups are applicable to all patients treated with complete surgical excision as first treatment and also require a complete pathology report, grade, and ER, PR, and HER2. Applying the pathologic prognostic stage groups to a large database of patients staged by basic TNM groupings changed the stage grouping of almost 40% of patients. Grouping by pathologic prognostic stage groups led to a better prognostic distribution of the group and more precise individual prognostication.

scholarly journals International Validation of the Eighth Edition of the American Joint Committee on Cancer (AJCC) TNM Staging System in Patients With Resected Pancreatic Cancer

JAMA Surgery ◽  
2018 ◽  
Vol 153 (12) ◽  
pp. e183617 ◽  
Author(s):  
Stijn van Roessel ◽  
Gyulnara G. Kasumova ◽  
Joanne Verheij ◽  
Robert M. Najarian ◽  
Laura Maggino ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
American Joint Committee ◽  
Tnm Staging System ◽  
Eighth Edition
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