%0 Journal Article
%T Proposed revision of N categories to the 8th edition of the AJCC©\TNM staging system for non©\surgical esophageal squamous cell cancer
%A Caitiao Lv
%A Dong Guo
%A Jiamei Lu
%A Jianxiong Long
%A Jinming Yu
%A Kai Hu
%A Ning Kang
%A Rensheng Wang
%A Tianmeng Tan
%A Wang Jing
%A Yang Liu
%A Yuyan Deng
%J Archive of "Cancer Science".
%D 2019
%R 10.1111/cas.13891
%X The 8th edition of the American Joint Committee on Cancer Tumor©\Node©\Metastasis (AJCC©\TNM) staging system for esophageal cancer (EC) retained the definition of N categories based on the number of metastatic lymph nodes (LN). However, it is difficult to accurately determine the number of metastatic LN without surgery. This study aimed to propose a revision to the N categories of the 8th edition AJCC©\TNM staging system that makes staging easier to perform and better represents the prognosis of non©\surgical esophageal squamous cell cancer (ESCC). We retrospectively reviewed the data of 336 patients with ESCC. The revised N categories were based on the anatomic regions of LN metastasis (cervix, thorax and abdomen). Survival was analyzed using the Kaplan©\Meier method and compared using the log©\rank test. Multivariate analyses were performed using the Cox proportional hazard model. Survival differences were adequately discriminated when the revised N categories were used. Subgroup analyses by T stage showed significant difference in overall survival between the revised N categories. Multivariate analyses demonstrated that T stage, revised N category, age, sex and treatment modality were independent risk factors, with the revised N category being the most significant variable. The revised N categories determined in this study can be used to fill gaps in the staging system for patients with non©\surgical ESCC, which can help clinicians to make better treatment decisions and more effectively predict patient prognoses. Future large©\scale studies are required to validate these results
%K AJCC©\TNM staging system
%K esophageal squamous cell cancer
%K N category
%K non©\surgical
%K prognosis
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361553/