Analysis of survival prediction value using modification 7th UICC esophageal cancer staging system for esophageal squamous cell carcinoma with preoperative radiotherapy
WANG Qi-feng, ZHANG Wen-cheng,XIAO Ze-fen, ZHANG Hong-xing, CHEN Dong-fu,FENG Qin-fu, ZHOU Zong-mei, Lv Ji-ma, LIANG Jun, WANG Lv-hua, YIN Wei-bo
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021, China Corresponding author:XIAO Ze-fen,Email:xiaozefen@sina.com
Abstract：Objective To evaluate the value of the international union against cancer (UICC) stage, pathologic complete response (pCR), and the estimated treatment response as various means for prognostic stratifying patients after surgery in patients with squamous cell carcinoma of the esophagus who received preoperative radiotherapy (RT). Methods A retrospective review was performed on 311 patients with esophageal squamous cell carcinoma who received RT before the esophagectomy. Data collected included the demographics, the RT details, the pathologic findings, and the survival. Prognostic survival was analyzed by Kaplan-Meier method and Logrank test. Results The follow-up rate was 96.5%, 89 and 43 patients, respectively were followed up more than 5 and 10 years. In univariate analysis, residual disease and the number of positive lymph node were predictors of the overall survival (T-pCR,χ2=11.53,P=0.001;0,1－3,≥4,χ2=42.13,P=0.000,respectively). Further study found the 7th stage system of UICC cannot (can or cannot) entirely predict the prognosis of this group of patients. If categorizing the stages of their lymph nodes into three groups:N0(0), N1(1－3) and N2(≥4)), and the modified UICC system can accurately distinguish ypStage Ⅰ with ypStage Ⅱ(T0-3N1M0+T3N0M0)(χ2=11.15,P=0.001) and ypStage Ⅱ with ypStage Ⅲ(T4N0－1M0 and T0-3N2M0)(χ2=23.39,P=0.000). Conclusions The pathologic post-radiotherapy T stage and the number of positive lymph node are predictors for esophageal squamous cell carcinoma receiving preoperative radiotherapy. The modified UICC stage system can be a better survival predictor than the 7th UICC stage system.
WANG Qi-feng,ZHANG Wen-cheng,XIAO Ze-fen et al. Analysis of survival prediction value using modification 7th UICC esophageal cancer staging system for esophageal squamous cell carcinoma with preoperative radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 217-220.
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2012, Vol. 21 
