Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study
Abstract Background The evaluation of the eighth edition of ypTNM staging system for patients with esophageal cancer was limited in the setting of neoadjuvant therapy. Methods A total of 2324 patients with esophageal cancer receiving radio(chemo)therapy prior to surgery from the Surveillance, Epidem...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2997 |
| _version_ | 1819000531971997696 |
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| author | Yonggang Yuan Ge Ma Xuelei Hu Qingyuan Huang |
| author_facet | Yonggang Yuan Ge Ma Xuelei Hu Qingyuan Huang |
| author_sort | Yonggang Yuan |
| collection | DOAJ |
| description | Abstract Background The evaluation of the eighth edition of ypTNM staging system for patients with esophageal cancer was limited in the setting of neoadjuvant therapy. Methods A total of 2324 patients with esophageal cancer receiving radio(chemo)therapy prior to surgery from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2013 were eligible for the analysis. Kaplan‐Meier method and Cox proportional hazards models were used to estimate overall survivals. Results Among patients with preoperative therapy, both the seventh edition TNM grouping and the eighth edition ypTNM grouping could significantly stratify the overall survival (both log‐rank P < .001). There was not significant difference in the C‐index of the seventh edition TNM grouping (0.575; 95%CI, 0.558‐0.593) and the eighth edition ypTNM grouping (0.569; 95%CI, 0.551‐0.587) (P = .098). In multivariable Cox analysis, ypN category was the strongest predictor of overall survival (P < .001), followed by tumor grade (HR, 1.33; 95%CI, 1.12‐1.56; P = .001). The combination of ypT, ypN, and ypG categories yielded significantly higher C‐index (0.591; 95%CI, 0.573‐0.609) than that of the seventh edition TNM staging (P = .024). Conclusion Tumor grade remained an independent predictor of overall survival in the setting of neoadjuvant therapy, and could improve the performance of ypTNM staging system. |
| first_indexed | 2024-12-20T22:34:48Z |
| format | Article |
| id | doaj.art-598a3e56c05942edb1f232feeb3a40b3 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-20T22:34:48Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-598a3e56c05942edb1f232feeb3a40b32022-12-21T19:24:38ZengWileyCancer Medicine2045-76342020-07-019134648465510.1002/cam4.2997Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER studyYonggang Yuan0Ge Ma1Xuelei Hu2Qingyuan Huang3Department of Thoracic Surgery Qilu Hospital of Shandong University(Qingdao) Qingdao P.R. ChinaDepartment of Respiratory Medicine Yidu Central Hospital of Weifang Weifang ChinaDepartment of Thoracic Surgery Qilu Hospital of Shandong University(Qingdao) Qingdao P.R. ChinaShanghai First People's HospitalShanghai Jiao Tong University Shanghai ChinaAbstract Background The evaluation of the eighth edition of ypTNM staging system for patients with esophageal cancer was limited in the setting of neoadjuvant therapy. Methods A total of 2324 patients with esophageal cancer receiving radio(chemo)therapy prior to surgery from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2013 were eligible for the analysis. Kaplan‐Meier method and Cox proportional hazards models were used to estimate overall survivals. Results Among patients with preoperative therapy, both the seventh edition TNM grouping and the eighth edition ypTNM grouping could significantly stratify the overall survival (both log‐rank P < .001). There was not significant difference in the C‐index of the seventh edition TNM grouping (0.575; 95%CI, 0.558‐0.593) and the eighth edition ypTNM grouping (0.569; 95%CI, 0.551‐0.587) (P = .098). In multivariable Cox analysis, ypN category was the strongest predictor of overall survival (P < .001), followed by tumor grade (HR, 1.33; 95%CI, 1.12‐1.56; P = .001). The combination of ypT, ypN, and ypG categories yielded significantly higher C‐index (0.591; 95%CI, 0.573‐0.609) than that of the seventh edition TNM staging (P = .024). Conclusion Tumor grade remained an independent predictor of overall survival in the setting of neoadjuvant therapy, and could improve the performance of ypTNM staging system.https://doi.org/10.1002/cam4.2997esophageal cancerneoadjuvant therapytumor gradeypTNM staging |
| spellingShingle | Yonggang Yuan Ge Ma Xuelei Hu Qingyuan Huang Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study Cancer Medicine esophageal cancer neoadjuvant therapy tumor grade ypTNM staging |
| title | Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study |
| title_full | Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study |
| title_fullStr | Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study |
| title_full_unstemmed | Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study |
| title_short | Evaluating the eighth edition TNM staging system for esophageal cancer among patients receiving neoadjuvant therapy: A SEER study |
| title_sort | evaluating the eighth edition tnm staging system for esophageal cancer among patients receiving neoadjuvant therapy a seer study |
| topic | esophageal cancer neoadjuvant therapy tumor grade ypTNM staging |
| url | https://doi.org/10.1002/cam4.2997 |
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