Proposed revision of the 8th edition AJCC clinical staging system for esophageal squamous cell cancer treated with definitive chemo-IMRT based on CT imaging
机构：[1]Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People’s Republic of China350014.[2]Fujian Provincial Platform for Medical Laboratory Research of First Affiliated Hospital, Fuzhou, Fujian, People’s Republic of China.[3]The Graduate School, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China.[4]Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China.[5]Fuzhou Center for Disease Control and Prevention, Fuzhou, Fujian, People’s Republic of China.[6]Cancer and Genetics Research Complex, Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, USA.[7]Department of Radiation Oncology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.[8]Institute of Radiotherapy & Oncology, Soochow University, Suzhou, Jiangsu, China.[9]Central Laboratory, the First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, People’s Republic of China350005.
Purpose: To validate and propose revision of the 8th edition American Joint Committee on Cancer (AJCC) clinical staging system for esophageal squamous cell cancer (ESCC) patients treated with definitive intensity-modulated radiation therapy combined with concurrent chemotherapy (Chemo-IMRT) based on computed tomography (CT) imaging. Methods: The clinical data of patients with ESCC treated with Chemo-IMRT were collected and retrospectively reviewed. All CT images were independently reevaluated and restaged according to the 8th edition AJCC staging system. The overall survival (OS) rates were analyzed statistically. ROC curves of the various parameters of the primary tumor and metastatic lymph nodes were generated in order to identify the cutoff values correlated to patient survival using the area under curve. Results: The gross tumor volume of the primary tumor (GTV-prT) and the clinical N stage (cN) were independent factors that influenced OS. The 5-year OS rate of patients with GTV-prT <= 28 cm(3), GTV-prT <= 28 and 5 56 cm(3), and GTV-prT < 56 cm(3) were 54.6, 31.1 and 18.6%, respectively. The 5-year OS rate of patients with cNO, cN1 SLNM (-), cN2 SLNM (-), cN3 SLNM (-) and SLNM (+) were 62.8 (P < 0.001), 34.0 (P = 0.16), 20.0 (P = 0.785), 0 (P < 0.001) and 26.9%, respectively. After restaging the SLNM as regional MLNs, the 5-year OS rates of the patients with cNO, 1, 2 and 3 were 62.8, 36.3, 23.7 and 7.8%, respectively. Various GTV-prT were combined with the cN to establish a new clinical TNM staging system: I, GTV-prT1 and cNO; II, GTV-prT2 or 3 and cNO, GTV-prT1 and cN1; Ill, GTV-prT1 and cN2, GTV-prT2 and cN1,2; Iva, GTV-prT3 and cN1,2; IVb, G1V-prT(any) and cN3; IVc, T-any N-any Ml. Subsequently, the OS differed significantly between the adjacent GTV-prT cN categories, except those of stage I vs. II. Conclusion: The SLNM should be dealt with as a regional rather than a distant disease in patients with ESCC when treated with CRT. The proposed nonsurgical staging system based on the GTV-prT and N appears to be a simple and accurate prognosis predictor for patients with ESCC who have undergone definitive Chemo-IMRT.
基金：
Fujian Provincial Health & Family Planning Commission [2016-ZQN-32]; Fujian Provincial Department of Science Technology [2017Y9079, 2018 J01306, 2018Y2003]; Fujian Provincial Platform for Medical Laboratory Research & Key Laboratory for Tumor Individualized Active Immunity [FYKFKT-2017015]
语种：
外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类|3 区医学
小类|3 区核医学4 区肿瘤学
最新[2023]版：
大类|2 区医学
小类|2 区核医学3 区肿瘤学
JCR分区：
出版当年[2017]版：
Q2RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGINGQ3ONCOLOGY
最新[2023]版：
Q1RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGINGQ2ONCOLOGY
第一作者机构：[1]Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People’s Republic of China350014.[2]Fujian Provincial Platform for Medical Laboratory Research of First Affiliated Hospital, Fuzhou, Fujian, People’s Republic of China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People’s Republic of China350014.[2]Fujian Provincial Platform for Medical Laboratory Research of First Affiliated Hospital, Fuzhou, Fujian, People’s Republic of China.
推荐引用方式(GB/T 7714)：
Mingqiu Chen,Xiqing Li,Yuangui Chen,et al.Proposed revision of the 8th edition AJCC clinical staging system for esophageal squamous cell cancer treated with definitive chemo-IMRT based on CT imaging[J].RADIATION ONCOLOGY.2019,14(1):54.doi:10.1186/s13014-019-1258-4.
APA：
Mingqiu Chen,Xiqing Li,Yuangui Chen,Pingping Liu,Zhiwei Chen...&Lengxi Fu.(2019).Proposed revision of the 8th edition AJCC clinical staging system for esophageal squamous cell cancer treated with definitive chemo-IMRT based on CT imaging.RADIATION ONCOLOGY,14,(1)
MLA：
Mingqiu Chen,et al."Proposed revision of the 8th edition AJCC clinical staging system for esophageal squamous cell cancer treated with definitive chemo-IMRT based on CT imaging".RADIATION ONCOLOGY 14..1(2019):54
