Proposal for improved staging criteria for carcinoma of the esophagus and cardia
| Autor: | Gerald J. Heatley, Karoly Balogh, F. H. Ellis |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Esophageal Neoplasms Adenocarcinoma Stage ii Prognostic stratification Barrett Esophagus Actuarial Analysis Stomach Neoplasms medicine Carcinoma Humans Esophagus Stage (cooking) Staging system Neoplasm Staging Retrospective Studies business.industry Reproducibility of Results Cancer Cardia General Medicine Prognosis medicine.disease Survival Analysis Surgery medicine.anatomical_structure Carcinoma Squamous Cell Radiology Cardiology and Cardiovascular Medicine business Stage iv |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 12:361-365 |
| ISSN: | 1010-7940 |
| Popis: | Objective: Current staging for carcinoma of the esophagus and cardia remains imprecise. In an effort to improve on presently accepted staging criteria, new and improved criteria were sought. Methods: A total of 408 specimens resected for carcinoma of the esophagus or cardia between January 1, 1970, and January 1, 1994, were available for analysis. Pathology reports were reviewed, and available histologic slides were examined microscopically. When necessary, paraffin blocks of excised specimens were recut for further pathologic evaluation. On the basis of these findings, tumors were staged according to the criteria of American Joint Committee on Cancer (AJCC). New criteria were established based on the WNM concept and staged accordingly. Survival rates based on these sets of criteria were calculated for each stage, and results were compared. Results: Because our previous studies had shown no advantage provided by the revised AJCC criteria compared with those originally proposed, we modified the WNM system by eliminating the subdivisions of Stage II, reducing the T categories by 1, T3 and T4 having shown no survival differences, and increasing the N categories by 1. depending on the number of nodes involved, e.g. NO = no positive nodes; N1 =1-4 positive nodes, and N2-5 or more positive nodes. The resulting staging system and 5-year survival rates obtained thereby are as follows: Stage O (TO, is, 1 NO), 88.2%; Stage I (T1N1, T2NO), 50.3%; Stage II (T2N1, T3N0) 22.5%; Stage III (T3N1, any T N2), 10.7%; and Stage IV (Ml) 0%. Conclusions: A new staging scheme for carcinoma of the esophagus and cardia is proposed that provides better prognostic stratification of patients than existing ones. |
| Databáze: | OpenAIRE |
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