title: Postchemoradiotherapy Pathologic Stage Classified by the American Joint Committee on the Cancer Staging System Predicts Prognosis of Patients with Locally Advanced Esophageal Squamous Cell Carcinoma.
abstract: BACKGROUND
  To determine whether the postchemoradiotherapy (post-CRT) pathologic stage predicts the outcomes of patients with locally advanced esophageal squamous cell carcinoma (ESCC) undergoing preoperative CRT followed by surgery.
  
  
  METHODS
  From three phase II trials of preoperative CRT for locally advanced ESCC, 140 patients were included. Preoperative CRT comprised twice weekly paclitaxel and cisplatin-based regimens and 40-Gy radiotherapy in 20 fractions. The post-CRT pathologic stage was classified according to the American Joint Committee on Cancer, 7th edition staging system. The prognostic effects of clinicopathologic factors were analyzed using Cox regression.
  
  
  RESULTS
  With a median follow-up of 61.9 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort were 24.5 and 30.9 months, respectively. The post-CRT pathologic stage was 0 in 34.5%, I in 12.9%, II in 29.3%, III in 13.6%, and ypT0N1-2 in 6.4% of the patients. The median PFS was 47.2, 25.9, 16.0, 9.4, and 15.1 months, and the median OS was 57.4, 34.1, 26.2, 14.1, and 17.6 months for patients with post-CRT pathologic stage 0, I, II, III, and ypT0N1-2, respectively. In multivariate analysis, performance status (p < 0.001), tumor location (p = 0.016), and extranodal extension (p = 0.024) were independent prognostic factors for PFS, whereas performance status (p < 0.001) and post-CRT pathologic stage (p = 0.027) were independent prognostic factors for OS.
  
  
  CONCLUSIONS
  The post-CRT pathologic stage classified by American Joint Committee on Cancer, 7th edition staging system predicted the survival of locally advanced ESCC patients who underwent preoperative paclitaxel and cisplatin-based CRT followed by esophagectomy.
authors: *Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan; †Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; ‡Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan; §Department of Pathology, ‖Department of Medical Research, ¶Department of Surgery, and #Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; and **Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Jhe-Cyuan
authors: JC
authors: Guo
authors: Ta-Chen
authors: TC
authors: Huang
authors: Chia-Chi
authors: CC
authors: Lin
authors: Min-Shu
authors: MS
authors: Hsieh
authors: Chin-Hao
authors: CH
authors: Chang
authors: Pei-Ming
authors: PM
authors: Huang
authors: Jang-Ming
authors: JM
authors: Lee
authors: Feng-Ming
authors: FM
authors: Hsu
authors: Jason
authors: J
authors: Chia-Hsien Cheng
authors: Hsiu-Po
authors: HP
authors: Wang
authors: Kun-Huei
authors: KH
authors: Yeh
authors: Ann-Lii
authors: AL
authors: Cheng
authors: Chih-Hung
authors: CH
authors: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D014481:United States; D014944:World Health Organization