Comprehensive registry of esophageal cancer in Japan, 2014

Background The registration committee for esophageal cancer in the Japan Esophageal Society (JES) has collected the patients' characteristics, treatment, and outcomes annually. Methods We analyzed the data of patients who had visited the participating hospitals in 2014. We collected the data with a web-based data collection system using the National Clinical Database. We used the Japanese Classification of Esophageal Cancer 10th edition by JES and the TNM classification 7th edition by the Union of International Cancer Control (UICC) for cancer staging. Results A total of 9026 cases were registered from 344 institutions in Japan. Squamous cell carcinoma and adenocarcinoma accounted for 87.9% and 7.1%, respectively. The 5-year survival rates of patients treated using endoscopic resection, concurrent chemoradiotherapy, radiotherapy alone, and esophagectomy were 87.1%, 33.7%, 25.3%, and 59.3%, respectively. Esophagectomy was performed in 5204 cases. Concerning the approach used for esophagectomy, 48.1% of the cases were treated thoracoscopically. The operative mortality (within 30 days after surgery) was 0.75%, and the hospital mortality was 2.0%. The survival curves showed an excellent discriminatory ability both in the clinical and pathologic stages by the JES system. The survival of pStage IV was better than IIIC in the UICC system, because pStage IV included the patients with supraclavicular lymph-node metastasis (M1 LYM). Conclusion We hope that this report contributes to improving all aspects of diagnosing and treating esophageal cancer in Japan.

1 3 using endoscopic resection, concurrent chemoradiotherapy, radiotherapy alone, and esophagectomy were 87.1%, 33.7%, 25.3%, and 59.3%, respectively. The endoscopic submucosal dissection accounted for 92.6% of endoscopic resection. Esophagectomy was performed in 5204 cases. Concerning the approach used for esophagectomy, 48.1% of the cases were treated thoracoscopically. The operative mortality (within 30 days after surgery) was 0.75%, and the hospital mortality was 2.0%. The Kaplan-Meier survival curves diverged according to the N-grade both in the JES and the UICC classifications. The survival curves showed an excellent discriminatory ability both in the clinical and pathologic stages by the JES system. In contrast, in the UICC system, the survival of cStage IIB was better than those of IB and IIA, while the survival curves were almost identical between cStage IIIc and IV. Also, the survival curve of pStage IIB was better than that of IIA, and the survival of pStage IV was better than that of IIIC. pStage IV in the UICC system included the patients with supraclavicular lymph-node metastasis (M1 LYM), which is probably the reason for the better prognosis of pStage IV than pStage IIIC.
We hope that this Comprehensive Registry of Esophageal Cancer in Japan 2014 will help to improve all aspects of the diagnosis and treatment of esophageal cancer in Japan.  Table 14 Treatment modalities of esophagectomy  Table 15 Tumor location  Table 16 Approaches to tumor resection  Table 17 Video-assisted surgery Table 18 Fields of lymph-node dissection according to the location of the tumor Table 19 Reconstruction route  Table 20 Organs used for reconstruction  Table 21 Histological classification  Table 22 Depth of tumor invasion, pT (JES 10th) Table 23 Pathological grading of lymph-node metastasis, pN (JES 10th)   Table 1 Age and gender  Table 2 Performed treatment  Table 3 Tumor location  Table 4 Histologic types of biopsy specimens Table 5 Depth of tumor invasion, cT (UICC TNM 7th) Table 6 Lymph-node metastasis, cN (UICC TNM 7th)  Table 9 Details of endoscopic treatment for curative intent Table 10 Complications of EMR/ESD Table 11

Declarations
Ethical statement All procedures followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.
Conflict of interest Shiyori Usune, Arata Takahashi, and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Co. Other authors have no conflict of interest.
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