Abstract
Previous staging of esophageal cancer was based on a simple, orderly arrangement of increasing anatomic T, then N, then M classifications. This system is consistent with neither data nor cancer biology. Recent worldwide collaboration has provided data for unique, modern machinelearning analysis that has resulted in a new, data-driven staging system for cancer of the esophagus and esophagogastric junction. This new system is presented in the seventh editions of the AJCC and UICC Cancer Staging Manuals. It is more representative of and consistent with the clinical reality of survival of patients with esophageal cancer. Changes address problems of empiric stage grouping and lack of harmonization with stomach cancer. In addition, for the first time, nonanatomic cancer characteristics such as tumor location, histologic grade, and histopathologic cell type are incorporated. The new era of data-driven staging of esophageal cancer promises a bright future for staging of all cancers. However, more extensive worldwide collaboration is required to refine and broaden TNM classifications and identify cancer and patient characteristics that influence esophageal cancer stage and impact survival.
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Rice TW, Rusch VW, Apperson-Hansen C, Allen MS, Chen LQ, Hunter JG, et al. Worldwide Esophageal Cancer Collaboration. Dis Esophagus 2009;22:1–8.
Ishwaran H, Blackstone EH, Apperson-Hansen C, Rice TW. A novel approach to cancer staging: application to esophageal cancer. Biostatistics 2009;10:603–620.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A III, editors. AJCC cancer staging manual. 7th edition. New York: Springer; 2009, p. 103–115.
Rice TW, Rusch VW, Ishwaran H, Blackstone EH. Cancer of the esophagus and esophagogastric junction: data-driven staging for the 7th edition of the AJCC cancer staging manual. Cancer (Phila) 2010;116:3763–3773.
Rice TW, Blackstone EH, Rusch VW. A cancer stating primer: esophagus and esophagogastric junction. J Thorac Cardiovasc Surg 2010;139:527–529.
Rusch VW, Rice TW, Crowley J, Blackstone EH, Rami-Porta R, Goldstraw P. The seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Staging Manuals: the new era of data-driven revisions. J Thorac Cardiovasc Surg 2010;139:819–821.
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Rice, T.W. Staging of esophageal cancer: TNM and beyond. Esophagus 7, 189–195 (2010). https://doi.org/10.1007/s10388-010-0246-4
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DOI: https://doi.org/10.1007/s10388-010-0246-4