Abstract：Objective To evaluate the predictive values of different systems for clinical staging of esophageal carcinoma in one group of patients and improve the criteria for T staging,and to provide a basis for accurate clinical staging. Methods A retrospective study was performed in 701 patients with esophageal carcinoma who received radical radiotherapy in our hospital. The prognosis was performed according to American Joint Committee on Cancer (AJCC) tumor-node-metastasis staging system,Chinese 2004 staging system,the draft of Chinese 2009 staging system,and gross tumor volume of the primary tumor (GTV-T). Results In terms of T stage,patients evaluated according to the AJCC staging system were in relatively early stages;23.1% of them were in stage T1,and the survival curves of T3 and T4 patients were close to each other;the survival curves plotted according to the Chinese 2004 staging system were well separated,but relatively few patients were in stages T1 and T4,yielding an uneven distribution;according to the draft of Chinese 2009 staging system,the survival curve of T3 patients intersected that of T4 patients,and up to 43.2% of patients were in stage T4.The new T staging was performed based on GTV and the extent of tumor invasion into the adjacent tissue and organ,and the results showed that there was no intersection between survival curves and a relatively balanced T stage distribution. In terms of N staging,patients were divided into stages N0,N1,and N2.The TNM staging was performed by a combination of N staging and new T staging,resulting in significant separation between survival curves (P=0.000). Conclusions The combination of T staging,which is based on GTV and the extent of tumor invasion,and N staging,which is based on metastasis of lymph nodes,can accurately predict the survival of non-surgically treated patients with esophageal carcinoma.
Zhu Shuchai,Yao Weinan,Li Juan et al. A comparative study of new clinical staging systems for esophageal carcinoma treated with non-surgical therapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 109-113.
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2016, Vol. 25 
