TY - CHAP M1 - Book, Section TI - Esophageal Cancer Staging 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 PY - 2015 T2 - Adult Chest Surgery, 2e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105838433 ER -