title: Metastatic lymph node ratio, 6th or 7th AJCC edition: witch is the best lymph node classification for esophageal cancer? Prognosis factor analysis in 487 patients.
abstract: BACKGROUND
  The esophageal cancer is one of the most common and aggressive worldwide. Recently, the AJCC changed the staging system, considering, among others, the important role of the lymph node metastasis on the prognosis.
  
  
  OBJECTIVE
  To discuss the applicability of different forms of lymph node staging in a western surgical center.
  
  
  METHODS
  Four hundred eighty seven patients with esophageal cancer were enrolled. Three staging systems were evaluated, the 6th and the 7th AJCC editions and the Lymph Node Metastatic Ratio.
  
  
  RESULTS
  The majority of the cases were squamous cell carcinoma. The mean lymph node sample was eight. Considering the survival, there was no significant difference between the patients when they were classified by the 7th AJCC edition. Analysis of the Lymph Node Metastatic Ratio, just on the group of patients with 0 to 25%, has shown significant difference (p=0,01). The 6th AJCC edition shows the major significant difference between among the classifications evaluated.
  
  
  CONCLUSIONS
  In this specific population, the 7th AJCC edition for esophageal cancer was not able to find differences in survival when just the lymph node analysis was considered.
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: Roberto V
authors.initials: RV
authors.lastname: Coral
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: André V
authors.initials: AV
authors.lastname: Bigolin
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: Roberto P
authors.initials: RP
authors.lastname: Coral
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Dranka
authors.affiliation: Department of Digestive Surgery, Santa Casa de Misericórdia Hospital, Porto Alegre, RS, Brazil.
authors.forename: Adriana V
authors.initials: AV
authors.lastname: Roehe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000145:classification* / Q000473:pathology / Q000556:secondary*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult