Prognostic Factors and Outcome for Patients with Esophageal Squamous Cell Carcinoma Underwent Surgical Resection Alone: Evaluation of the Seventh Edition of the American Joint Committee on Cancer Staging System for Esophageal Squamous Cell Carcinoma

Chen, Shao-bin; Weng, Hong-rui; Wang, Geng; Yang, Junjun; Yang, Wei; Liu, Di-tian; Chen, Yuping; Zhang, Hao

doi:10.1097/jto.0b013e3182829e2c

Cited by 59 publications

(55 citation statements)

References 23 publications

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“…pT category was another independent prognostic factor for early ESCC in our study group, which was similar to those of many previous studies (Endo et al, 2000;Stein et al, 2005;Wijnhoven et al, 2007;Gertler et al, 2011). Previous studies recommended that T1 stage should be subdivided according to the depths of infiltration rather than the histologic grade (Gertler et al, 2011), and we have confirmed this in our previous report (Chen et al, 2013).…”

Section: Discussionsupporting

confidence: 81%

Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

Chen

Weng²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma (ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC, evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affecting lymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwent transthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed. The χ 2 test or Fisher's exact test were used to detect factors related to lymph node metastasis. Univariate and multivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females with a median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining 20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computed tomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients with carcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumours and 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph node metastases in the follow-up. The 5-and 10-year overall survival rates were 81.4% and 70.1%, respectively. Only histologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph node metastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independent prognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade and pT category affected the presence of lymph node metastases and were independent prognostic factors for early ESCC.

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Section: Discussionsupporting

confidence: 81%

Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

Chen

Weng²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…In line with previous study (16), we found that T1a patients (85.7%) had a higher 3-year survival rate than T1b patients (78.4%). This could be due to the different risk of nodes metastases in pT1a and pT1b tumors (0-1.8% vs. 17.5-21%) (16,17). Our results demonstrated that significant discrepancy of 3-year survival were seen among T3 (54.4%), T4a (39.1%) and T4b (18.5%).…”

Section: Discussionmentioning

confidence: 52%

Evaluation of the 7th edition of the UICC-AJCC tumor, node, metastasis classification for esophageal cancer in a Chinese cohort

et al. 2016

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Background: To assess and evaluate the prognostic value of the 7 th edition of the Union for InternationalCancer Control-American Joint Committee on Cancer (UICC-AJCC) tumor, node, metastasis (TNM) staging system for Chinese patients with esophageal cancer in comparison with the 6 th edition. Methods: A retrospective review was performed on 766 consecutive esophageal cancer patients treated with esophagectomy between 2008 and 2012. Patients were staged according to the 6 th and 7 th editions for esophageal cancer respectively. Survival was calculated by the Kaplan-Meier method, and multivariate analysis was performed using Cox regression model. Results: Overall 3-year survival rate was 59.5%. There were significant differences in 3-year survival rates among T stages both according to the 6 th edition and the 7 th edition (P<0.001). According to the 7 th edition, the 3-year survival rates of N0 (75.4%), N1 (65.2%), N2 (39.7%) and N3 (27.3%) patients were significant differences (P<0.001). Kaplan-Meier curve revealed a good discriminatory ability from stage I to IV, except for stage IB, IIA and IIB in the 7 th edition staging system. Based on the 7 th edition, the degree of differentiation, tumor length and tumor location were not independent prognostic factors on multivariate analysis. The multivariate analyses suggested that pT-, pN-, pTNM-category were all the independent prognostic factors based on the 6 th and 7 th edition staging system. Conclusions: The 7 th edition of AJCC TNM staging system of esophageal cancer should discriminate pT2-3N0M0 (stage IB, IIA and IIB) better when considering the esophageal squamous cell cancer patients.Therefore, to improve and optimize the AJCC TNM classification for Chinese patients with esophageal cancer, more considerations about the value of tumor grade and tumor location in pT2-3N0M0 esophageal squamous cell cancer should be taken in the next new TNM staging system.

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“…In previous studies, lymph node metastasis has been reported to be an important prognostic factor in patients with ESCC [21], [22]. Therefore, the correlation between lymph node metastasis and ESCC patient prognosis was also investigated in this study.…”

Section: Resultsmentioning

confidence: 95%

Activating Transcription Factor 4 Promotes Esophageal Squamous Cell Carcinoma Invasion and Metastasis in Mice and Is Associated with Poor Prognosis in Human Patients

et al. 2014

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BackgroundActivating transcription factor 4 (ATF4) is a stress response gene that is involved in homeostasis and cellular protection. However, its expression and function in esophageal squamous cell carcinoma (ESCC) remains unknown. In this study, we aimed to determine the clinicopathologic significance of ATF4 in ESCC and its potential role in ESCC invasion and metastasis.Methodology/Principal FindingsWe demonstrated that ATF4 overexpression is correlated with multiple malignant characteristics and indicates poor prognosis in ESCC patients. ATF4 expression was an independent factor that affected the overall survival of patients with ESCC after surgical resection. ATF4 promoted cell invasion and metastasis by promoting matrix metalloproteinase (MMP)-2 and MMP-7 expression, while its silencing significantly attenuated these activities both in vitro and in vivo.Conclusions/SignificanceWe report that ATF4 is a potential biomarker for ESCC prognosis and that its dysregulation may play a key role in the regulation of invasion and metastasis in ESCC cells. The targeting of ATF4 may provide a new strategy for blocking ESCC metastasis.

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Prognostic Factors and Outcome for Patients with Esophageal Squamous Cell Carcinoma Underwent Surgical Resection Alone: Evaluation of the Seventh Edition of the American Joint Committee on Cancer Staging System for Esophageal Squamous Cell Carcinoma

Abstract: The seventh edition of the AJCC staging system for ESCC is acceptable in predicting survival. However, tumor location does not influence survival in our study. Subdivisions of pT1N0M0 cancers and the N-classification may need to be modified.

Cited by 59 publications

References 23 publications

Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

Evaluation of the 7th edition of the UICC-AJCC tumor, node, metastasis classification for esophageal cancer in a Chinese cohort

Activating Transcription Factor 4 Promotes Esophageal Squamous Cell Carcinoma Invasion and Metastasis in Mice and Is Associated with Poor Prognosis in Human Patients

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