State Key Laboratory of Oncology in South China, Cancer Center, Department of Thoracic Surgery, Sun Yat-sen University, Guangzhou, China.
Ann Surg Oncol. 2013 Feb;20(2):580-5. doi: 10.1245/s10434-012-2656-0. Epub 2012 Sep 27.
The 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual incorporates tumor grade and location for staging pT2-3N0M0 esophageal squamous cell carcinoma. Patients with pT3N0M0, classified as stage IIa according to the 6th edition of the AJCC cancer staging manual, can now be classified as stage Ib, IIa, or IIb. We aimed to discuss whether these changes affect survival and determine other potential prognostic factors.
We retrospectively analyzed 302 patients with postoperative pathologic stage T3N0M0 who underwent esophagectomy between 1990 and 2005 at Sun Yat-sen University Cancer Center. We performed univariate and multivariate analyses to identify prognostic factors for survival and used the Kaplan-Meier method to compare survival difference in each prognostic factor, including tumor grade and location.
The 5-year overall survival rate was 46 %, with a median survival of 1,244.5 days. Gender, age, alcohol consumption, forced expiratory volume in 1 s (FEV1), and number of removed lymph nodes were independent prognostic factors in both univariate and multivariate analyses. Smoking was also a prognostic factor in survival analysis by the Kaplan-Meier method. However, histologic tumor grade and location had no significant influence on patient survival.
Age, gender, alcohol consumption, FEV1, number of removed lymph nodes, and cigarette smoking are independent prognostic factors in patients with pT3N0M0 esophageal squamous cell carcinoma. However, tumor grade and location may not be as strong predictors in these patients as indicated in the 7th edition of the AJCC cancer staging manual.
第 7 版美国癌症联合委员会（AJCC）癌症分期手册将肿瘤分级和位置纳入 pT2-3N0M0 食管鳞状细胞癌分期。根据第 6 版 AJCC 癌症分期手册，pT3N0M0 患者被归类为 IIA 期，现在可以归类为 Ib、IIa 或 IIb 期。我们旨在讨论这些变化是否影响生存并确定其他潜在的预后因素。
我们回顾性分析了 1990 年至 2005 年在中山大学肿瘤中心接受食管癌根治性手术后病理分期为 T3N0M0 的 302 例患者。我们进行了单因素和多因素分析，以确定生存的预后因素，并使用 Kaplan-Meier 方法比较每个预后因素（包括肿瘤分级和位置）的生存差异。
5 年总生存率为 46%，中位生存时间为 1244.5 天。在单因素和多因素分析中，性别、年龄、饮酒、1 秒用力呼气量（FEV1）和切除的淋巴结数量均为独立的预后因素。吸烟也是 Kaplan-Meier 方法生存分析中的预后因素。然而，组织学肿瘤分级和位置对患者生存没有显著影响。
年龄、性别、饮酒、FEV1、切除的淋巴结数量和吸烟是 pT3N0M0 食管鳞状细胞癌患者的独立预后因素。然而，肿瘤分级和位置在第 7 版 AJCC 癌症分期手册中可能不如提示的那样是这些患者的强有力预测因素。
