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Dis Esophagus. 2016 Oct;29(7):724-733. doi: 10.1111/dote.12520.

Worldwide Esophageal Cancer Collaboration: pathologic staging data.

Author information

1
Cleveland Clinic, Cleveland, Ohio, USA. ricet@ccf.org.
2
West China Hospital of Sichuan University, Chengdu, Sichuan, China.
3
University of Texas MD Anderson Hospital, Houston, Texas, USA.
4
University of Queensland, Princess Alexandra Hospital, Brisbane, Australia.
5
Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
6
Erasmus Medical Center, Rotterdam, The Netherlands.
7
Beijing Cancer Hospital, Beijing, China.
8
Guy's & St Thomas' Hospitals, London, England.
9
Hôpital Nord, Marseille, France.
10
Indiana University Medical Center, Indianapolis, Indiana, USA.
11
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
12
Department of Surgery, The University of Chicago, Chicago, Illinois, USA.
13
Helsinki University Hospital, Helsinki, Finland.
14
University Medical Center Utrecht, Utrecht, The Netherlands.
15
Shanghai Chest Hospital, Shanghai, China.
16
Hospital de Clinicas, University of Buenos Aires, Buenos Aires, Argentina.
17
University of São Paulo School of Medicine, São Paulo, Brazil.
18
Royal Marsden NHS Foundation Trust, London, UK.
19
Section of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
20
Hospital Universitario del Mar, Barcelona, Spain.
21
University of Newcastle upon Tyne, Newcastle, United Kingdom.
22
University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
23
Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
24
Mayo Clinic, Rochester, Minnesota, USA.
25
University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.
26
University of Rochester, Rochester, New York, USA.
27
Toronto General Hospital, Toronto, Ontario, Canada.
28
Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
29
University of Montreal, Montreal, Quebec, Canada.
30
Medical University of South Carolina, Charleston, South Carolina, USA.
31
Oregon Health & Science University, Portland, Oregon, USA.
32
University Ziekenhuizen Leuven, Leuven, Belgium.
33
University of Michigan, Ann Arbor, Michigan, USA.
34
University of Miami, Miami, Florida, USA.
35
Case Western Reserve University, Cleveland, Ohio, USA.
36
Cleveland Clinic, Cleveland, Ohio, USA.

Abstract

We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 13,300 patients, 5,631 had squamous cell carcinoma, 7,558 adenocarcinoma, 85 adenosquamous carcinoma, and 26 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (51%), little weight loss (1.8 kg), 0-2 ECOG performance status (83%), and a history of smoking (70%). Cancers were pT1 (24%), pT2 (15%), pT3 (50%), pN0 (52%), pM0 (93%), and pG2-G3 (78%); most involved distal esophagus (71%). Non-risk-adjusted survival for both squamous cell carcinoma and adenocarcinoma was monotonic and distinctive across pTNM. Survival was more distinctive for adenocarcinoma than squamous cell carcinoma when pT was ordered by pN. Survival for pTis-1 adenocarcinoma was better than for squamous cell carcinoma, although monotonic and distinctive for both. WECC pathologic staging data is improved over that of the 7th edition, with more patients studied and patient and cancer variables collected. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient, cancer, and treatment characteristics, and should direct 9th edition data collection. However, the role of pure pathologic staging as the principal point of reference for esophageal cancer staging is waning.

KEYWORDS:

cancer staging; decision-making; esophagectomy; prognostication; survival

PMID:
27731547
PMCID:
PMC5731491
DOI:
10.1111/dote.12520
[Indexed for MEDLINE]
Free PMC Article

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