title: New TNM staging system for esophageal cancer: what chest radiologists need to know.
abstract: Esophageal cancer is a leading cause of cancer-related deaths worldwide, and the 5-year relative survival rate remains less than 20% in the United States. The treatment of esophageal cancer should be stage specific for better clinical outcomes. Recent treatment paradigms tend to involve a multimodality approach to management, which includes surgical resection and preoperative or definitive chemoradiation therapy. Accurate pretreatment staging of esophageal cancer is integral for assessing operability and determining a suitable treatment plan. The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) have published the seventh edition of the staging manual for cancer in the esophagus and esophagogastric junction. Unlike the sixth edition, the revised staging manual is data driven and harmonized with the staging of stomach cancer. Improvements include new definitions for the anatomic classifications Tis, T4, regional lymph node, N, and M and the addition of nonanatomic cancer characteristics (histopathologic cell type, histologic grade, and cancer location). Given the recent increase in the incidence of adenocarcinoma of the distal esophagus, esophagogastric junction, and gastric cardia, the staging of tumors in the esophagogastric junction has been addressed. Radiologists must understand the details of the seventh edition of the AJCC-UICC staging system for esophageal cancer and use appropriate imaging modalities, such as computed tomography (CT), endoscopic ultrasonography, and positron emission tomography/CT, for initial staging.
authors.affiliation: From the Departments of Radiology (S.J.H., T.J.K., K.B.N., I.S.L., K.W.L.) and Thoracic Surgery (H.C.Y., S.C., K.K., S.J.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 300 Gumi-dong, Bundang-gu, Seonagnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Kim
authors.forename: Kyung Bum
authors.initials: KB
authors.lastname: Nam
authors.forename: In Sun
authors.initials: IS
authors.lastname: Lee
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yang
authors.forename: Sukki
authors.initials: S
authors.lastname: Cho
authors.forename: Kwhanmien
authors.initials: K
authors.lastname: Kim
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Jheon
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
mesh_terms: D003952:Diagnostic Imaging; D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D060787:Neoplasm Grading; D009367:Neoplasm Staging