Refining esophageal cancer staging

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Presentation transcript:

Refining esophageal cancer staging Thomas W. Rice, MDa, Eugene H. Blackstone, MDa,b, Lisa A. Rybicki, MSb, David J. Adelstein, MDc, Sudish C. Murthy, MD, PhDa, Malcolm M. DeCamp, MDa, John R. Goldblum, MDd The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 5, Pages 1103-1113 (May 2003) DOI: 10.1067/mtc.2003.170 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Survival after esophagectomy according to T classification in pN0 M0 disease. A, Current classification. Number of patients in each classification and number traced at 5 years, respectively, were as follows: Tis (44 and 21), T1 (98 and 26), T2 (31 and 8), T3 (57 and 12), and T4 (4 and 0). B, Proposed subclassification of T1 into T1a (intramucosal, n = 66, 18 traced at 5 years) and T1b (submucosal, n = 32, 8 traced at 5 years). Shown for reference are Tis (HGD) and T2. Vertical bars represent 68% confidence limits. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Survival after esophagectomy in pN1 M0 disease. A, pN1 disease (n = 204, 12 traced at 5 years) contrasted with pN0 disease (n = 234, 67 traced at 5 years). B, pN1 disease stratified according to the number of regional lymph nodes containing metastatic cancer: 1 or 2 nodes (n = 83, 10 traced at 5 years) or 3 or more nodes (n = 121, 2 traced at 5 years). C, pN1 disease stratified according to T. Number of patients in each subclassification and number traced at 5 years, respectively, were as follows: T1 (11 and 1), T2 (17 and 1), T3 (169 and 9), and T4 (7 and 1). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Survival after esophagectomy stratified by M1a (n = 26, none alive at 5 years) and M1b (n = 16, none alive at 5 years). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Survival after esophagectomy according to current AJCC stage groupings. Number of patients in each grouping and number traced at 5 years, respectively, were as follows: 0 (44 and 21), I (98 and 26), IIA (88 and 20), IIB (28 and 2), III (100 and 10), IVA (26 and 0), and IVB (16 and 0). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Survival after esophagectomy according to refined stage groupings free of AJCC constraints (unconstrained). Number of patients in each grouping and number traced at 5 years, respectively, were as follows: I (110 and 39), II (49 and 16), III (138 and 22), and IV (167 and 2). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Appendix Fig. 1. Recursive partitioning analysis of TNM classification using log-rank method. Within partitions are (1) number of patients and (2) median survival (years). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Appendix Fig. 2. Survival after esophagectomy according to refined stage groupings. A, Groupings constrained by AJCC definitions of stages 0 and IV. Number of patients in each grouping and number traced at 5 years, respectively, were as follows: 0 (44 and 21), I (66 and 18), IIA (34 and 8), IIB (31 and 8), IIIA (72 and 14), IIIB (66 and 8), IIIC (125 and 2), and IV (42 and 0). B, Groupings free of AJCC constraints. Number of patients in each grouping and number traced at 5 years, respectively, were as follows: I (110 and 39), IIA (34 and 8), IIB (31 and 8), IIIA (72 and 14), IIIB (66 and 8), IVA (125 and 2), and IVB (42 and 0). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1103-1113DOI: (10.1067/mtc.2003.170) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions