Erschienen in:
01.10.2020 | ASO Author Reflections
ASO Author Reflections: ypTNM Stage Grouping in the 8th Edition of the AJCC Cancer Staging Manual Refines the Prognostic Prediction for Patients with Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemotherapy
verfasst von:
Natsuru Sudo, MD, PhD, Hiroshi Ichikawa, MD, PhD, Yusuke Muneoka, MD, PhD, Takaaki Hanyu, MD, PhD, Yosuke Kano, MD, PhD, Takashi Ishikawa, MD, PhD, Yuki Hirose, MD, PhD, Kohei Miura, MD, PhD, Yoshifumi Shimada, MD, PhD, Masayuki Nagahashi, MD, PhD, Jun Sakata, MD, PhD, Takashi Kobayashi, MD, PhD, Takeo Bamba, MD, PhD, Satoru Nakagawa, MD, PhD, Shin-ichi Kosugi, MD, PhD, Toshifumi Wakai, MD, PhD, FACS
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 2/2021
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Excerpt
Cancer staging has a pivotal role in cancer treatment, to predict the prognosis and determine the best treatment strategy for each patient. The American Joint Committee on Cancer (AJCC) published the first edition of the
AJCC Cancer Staging Manual in 1977. In the AJCC 3rd edition, the prefix “y” was first introduced to the tumor-node-metastasis (TNM) staging system for cases that have the initial multimodality (systemic and/or radiation) therapy before surgery (neoadjuvant therapy). Until the TNM staging system in the AJCC 7th edition, the pathologic stage was evaluated using the identical stage grouping regardless of the presence or absence of neoadjuvant therapy.
1 Multidisciplinary treatment combining surgery with neoadjuvant chemoradiotherapy or chemotherapy has been attempted to improve the dismal prognosis of locally advanced esophageal cancer.
2 According to the Worldwide Esophageal Cancer Collaboration (WECC) database, the prognosis after neoadjuvant therapy followed by surgery is not equivalent to that after surgery alone in the same pathologic category.
3 Considering these circumstances, the TNM staging system in the AJCC 8th edition for esophageal cancer provided a specific pathologic TNM stage grouping after neoadjuvant therapy (ypTNM) that differs from the grouping after surgery alone.
4 However, patients with esophageal adenocarcinoma originating from Western countries who received neoadjuvant chemoradiotherapy were predominantly included in the WECC database.
3 Therefore, the advantage of the novel ypTNM stage grouping in the AJCC 8th edition was not fully confirmed, especially for Asian patients with esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant chemotherapy. …
