• Chia-Chun Wang, Jason Chia-Hsien Cheng, Chiao-Ling Tsai, Jang-Ming Lee, Pei-Ming Huang, Chia-Chi Lin, Chih-Hung Hsu, Min-Shu Hsieh, Yih-Leong Chang, and Feng-Ming Hsu.
• Department of Oncology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
• Radiother Oncol. 2015 Apr 1; 115 (1): 9-15.

Background And PurposeTo assess the usefulness of pathological stage according to the 7th edition of the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC) as a prognostic tool in patients undergoing neoadjuvant chemoradiation followed by esophagectomy (trimodality therapy, TMT) for locally advanced esophageal squamous cell carcinoma.Material And MethodsOne hundred twenty-five eligible patients completing TMT were enrolled for analysis. The clinical (cTNM7) and pathological (ypTNM7) stage groups of their tumors were prospectively classified, and re-grouped by the 6th edition (ypTNM6). Survival was analyzed using the Kaplan-Meier method. The Cox proportional hazard model and the Akaike information criterion (AIC) were used to compare the performance of staging systems.ResultsWith a median follow-up of 24.6 months, 54 patients (43.2%) died. Forty patients (32%) achieved pathological complete remission (pCR). The median survival was 31.8 months. On multivariate analysis, ypTNM7 (but not pCR or pN) was the only independent factor affecting overall survival (p<0.001). The ypTNM7 was superior to cTNM7 or ypTNM6 in predicting both overall and recurrence-free survival after TMT based on AIC values and Cox proportional hazard model analysis.ConclusionsIn patients with locally advanced esophageal squamous cell carcinoma undergoing TMT, ypTNM7 is the best predictor of survival.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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