Comparison of the 8th UICC staging system for esophageal and gastric cancers in Siewert type II junctional adenocarcinomas
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Comparison of the 8th UICC staging system for esophageal and gastric cancers in Siewert type II junctional adenocarcinomas. / Karstens, Karl-Frederick; Ghadban, Tarik; Sawez, Sahar; Konczalla, Leonie; Woestemeier, Anna; Bachmann, Kai; Uzunoglu, Faik G; Tachezy, Michael; Vettorazzi, Eik; Izbicki, Jakob R; Reeh, Matthias.
in: EJSO-EUR J SURG ONC, Jahrgang 46, Nr. 4 Pt A, 04.2020, S. 638-643.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Comparison of the 8th UICC staging system for esophageal and gastric cancers in Siewert type II junctional adenocarcinomas
AU - Karstens, Karl-Frederick
AU - Ghadban, Tarik
AU - Sawez, Sahar
AU - Konczalla, Leonie
AU - Woestemeier, Anna
AU - Bachmann, Kai
AU - Uzunoglu, Faik G
AU - Tachezy, Michael
AU - Vettorazzi, Eik
AU - Izbicki, Jakob R
AU - Reeh, Matthias
N1 - Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
PY - 2020/4
Y1 - 2020/4
N2 - BACKGROUND: The aim of this study is to evaluate whether adenocarcinomas of the esophagogastric junction (AEG) are better staged as cancers of the esophagus (TNM-EC) or stomach (TNM-GC) according to the 8th edition of the UICC classification.METHODS: A single-center cohort of 246 patients operated on for AEG type II was staged according to the 8th edition of the UICC classification for esophageal and stomach cancer. Kaplan-Meier and univariate Cox regression analyses were performed to investigate the impact on survival.RESULTS: For AEG type II TNM-EC classified most of the patients (n = 126; 51.2%) to UICC stage IIIC and IVA while TNM-GC more evenly distributed the patients over the stages. Hazard ratios increased in between all stages in a stepwise manner except between stage IA and IIA for TNM-EC and between stage IIB and IIIA for TNM-GC. Survival curves for TNM-GC demonstrated significant differences between all four major UICC stages, while in TNM-EC no significant difference between stage I and II was found. When comparing the area under the curves of both staging systems a marginal superiority for TNM-EC was found.CONCLUSION: Neither the esophageal nor the stomach staging system is flawless in predicting survival in AEG type II. A marginal superiority of the TNM-EC was found in discriminating survival rates after three and five years. However, the advantage of the TNM-GC lies in the division of the N3 category into N3a and N3b. We therefor suggest a similar division in future TNM-EC classifications to improve its prognostic value.
AB - BACKGROUND: The aim of this study is to evaluate whether adenocarcinomas of the esophagogastric junction (AEG) are better staged as cancers of the esophagus (TNM-EC) or stomach (TNM-GC) according to the 8th edition of the UICC classification.METHODS: A single-center cohort of 246 patients operated on for AEG type II was staged according to the 8th edition of the UICC classification for esophageal and stomach cancer. Kaplan-Meier and univariate Cox regression analyses were performed to investigate the impact on survival.RESULTS: For AEG type II TNM-EC classified most of the patients (n = 126; 51.2%) to UICC stage IIIC and IVA while TNM-GC more evenly distributed the patients over the stages. Hazard ratios increased in between all stages in a stepwise manner except between stage IA and IIA for TNM-EC and between stage IIB and IIIA for TNM-GC. Survival curves for TNM-GC demonstrated significant differences between all four major UICC stages, while in TNM-EC no significant difference between stage I and II was found. When comparing the area under the curves of both staging systems a marginal superiority for TNM-EC was found.CONCLUSION: Neither the esophageal nor the stomach staging system is flawless in predicting survival in AEG type II. A marginal superiority of the TNM-EC was found in discriminating survival rates after three and five years. However, the advantage of the TNM-GC lies in the division of the N3 category into N3a and N3b. We therefor suggest a similar division in future TNM-EC classifications to improve its prognostic value.
U2 - 10.1016/j.ejso.2019.12.011
DO - 10.1016/j.ejso.2019.12.011
M3 - SCORING: Journal article
C2 - 31879051
VL - 46
SP - 638
EP - 643
JO - EJSO-EUR J SURG ONC
JF - EJSO-EUR J SURG ONC
SN - 0748-7983
IS - 4 Pt A
ER -