Worldwide Esophageal Cancer Collaboration: clinical staging data

Summary
To address uncertainty of whether clinical stage groupings (cTNM) for esophageal cancer share prognostic implications with pathologic groupings after esophagectomy alone (pTNM), we report data—simple descriptions of patient characteristics, cancer categories, and non–risk‐adjusted survival—for clinically staged patients from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty‐three institutions from six continents submitted data using variables with standard definitions: demographics, comorbidities, clinical cancer categories, and all‐cause mortality from first management decision. Of 22,123 clinically staged patients, 8,156 had squamous cell carcinoma, 13,814 adenocarcinoma, 116 adenosquamous carcinoma, and 37 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (18.5–25 mg/kg2, 47%), little weight loss (2.4 ± 7.8 kg), 0‐1 ECOG performance status (67%), and history of smoking (67%). Cancers were cT1 (12%), cT2 (22%), cT3 (56%), cN0 (44%), cM0 (95%), and cG2‐G3 (89%); most involved the distal esophagus (73%). Non–risk‐adjusted survival for squamous cell carcinoma was not distinctive for early cT or cN; for adenocarcinoma, it was distinctive for early versus advanced cT and for cN0 versus cN+. Patients with early cancers had worse survival and those with advanced cancers better survival than expected from equivalent pathologic categories based on prior WECC pathologic data. Thus, clinical a...

Source: Diseases of the Esophagus - October 11, 2016 Category: Gastroenterology Authors: T. W. Rice, C. Apperson ‐Hansen, L. M. DiPaola, M. E. Semple, T. E. M. R. Lerut, M. B. Orringer, L.‐Q. Chen, W. L. Hofstetter, B. M. Smithers, V. W. Rusch, B. P. L. Wijnhoven, K. N. Chen, A. R. Davies, X. B. D'Journo, K. A. Kesler, J. D. Luketich, M. Tags: WECCS Manuscripts Source Type: research