RT Book, Section
A1 Rice, Thomas W.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Colson, Yolonda L.
A2 Jaklitsch, Michael T.
A2 Krasna, Mark J.
A2 Mentzer, Steven J.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1105838433
T1 Esophageal Cancer Staging
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105838433
RD 2024/04/19
AB Cancer  staging  is  an  evolutionary  process.  The  Tumor-Node-Metastasis  (TNM)  esophageal  cancer  staging,  first  introduced  in  1968,  rapidly  developed,  but  unfortunately  then  stagnated  for  decades.  T  classifications  had  not  changed  since  1988,  N  classifications  for  thoracic  esophageal  cancer  since  1977,  and  M  classifications  since  1997.  The  principal  hindrance  to  evolution  was  the  long  held  concept  of  stage  groupings  of  esophageal  cancer  which  was  incorrectly  based  on  a  simple,  orderly  arrangement  of  increasing  anatomic  T,  then  N,  then  M  classifications.  This  assumption  was  consistent  with  neither  cancer  biology  nor  survival  data.  Worldwide  collaboration1  has  provided  data  for  a  unique,  modern  machine-learning  analysis2  that  has  produced  data-driven  staging  for  cancer  of  the  esophagus  and  esophagogastric  junction  (EGJ).3  This  new  system  is  the  basis  for  the  7th  editions  of  the  AJCC  and  UICC  Cancer  Staging  Manuals.4,5  It  is  more  representative  of  and  consistent  with  the  survival  following  esophagectomy  of  patients  with  esophageal  cancer.  The  changes  address  problems  of  empiric  stage  grouping  and  prior  disharmony  with  stomach  cancer  staging.  In  addition,  TNM  classifications  have  been  reviewed  and  revised  where  data  analysis  and  consensus  demonstrated  a  need  for  change.  For  the  first  time,  nonanatomic  cancer  characteristics,  primary  cancer  site  (location),  histologic  grade  (grade),  and  histopathologic  type  (cell  type)  are  incorporated  in  esophageal  cancer  staging.