title: Worldwide Esophageal Cancer Collaboration: pathologic staging data.
abstract: We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 13,300 patients, 5,631 had squamous cell carcinoma, 7,558 adenocarcinoma, 85 adenosquamous carcinoma, and 26 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (51%), little weight loss (1.8 kg), 0-2 ECOG performance status (83%), and a history of smoking (70%). Cancers were pT1 (24%), pT2 (15%), pT3 (50%), pN0 (52%), pM0 (93%), and pG2-G3 (78%); most involved distal esophagus (71%). Non-risk-adjusted survival for both squamous cell carcinoma and adenocarcinoma was monotonic and distinctive across pTNM. Survival was more distinctive for adenocarcinoma than squamous cell carcinoma when pT was ordered by pN. Survival for pTis-1 adenocarcinoma was better than for squamous cell carcinoma, although monotonic and distinctive for both. WECC pathologic staging data is improved over that of the 7th edition, with more patients studied and patient and cancer variables collected. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient, cancer, and treatment characteristics, and should direct 9th edition data collection. However, the role of pure pathologic staging as the principal point of reference for esophageal cancer staging is waning.
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA. ricet@ccf.org.
authors.forename: T W
authors.initials: TW
authors.lastname: Rice
authors.affiliation: West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: L-Q
authors.initials: LQ
authors.lastname: Chen
authors.affiliation: University of Texas MD Anderson Hospital, Houston, Texas, USA.
authors.forename: W L
authors.initials: WL
authors.lastname: Hofstetter
authors.affiliation: University of Queensland, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: B M
authors.initials: BM
authors.lastname: Smithers
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: V W
authors.initials: VW
authors.lastname: Rusch
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: B P L
authors.initials: BP
authors.lastname: Wijnhoven
authors.affiliation: Beijing Cancer Hospital, Beijing, China.
authors.forename: K L
authors.initials: KL
authors.lastname: Chen
authors.affiliation: Guy's & St Thomas' Hospitals, London, England.
authors.forename: A R
authors.initials: AR
authors.lastname: Davies
authors.affiliation: Hôpital Nord, Marseille, France.
authors.forename: X B
authors.initials: XB
authors.lastname: D'Journo
authors.affiliation: Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Kesler
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Luketich
authors.affiliation: Department of Surgery, The University of Chicago, Chicago, Illinois, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Ferguson
authors.affiliation: Helsinki University Hospital, Helsinki, Finland.
authors.forename: J V
authors.initials: JV
authors.lastname: Räsänen
authors.affiliation: University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Hillegersberg
authors.affiliation: Shanghai Chest Hospital, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Fang
authors.affiliation: Hospital de Clinicas, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: L
authors.initials: L
authors.lastname: Durand
authors.affiliation: University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: I
authors.initials: I
authors.lastname: Cecconello
authors.affiliation: Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: W H
authors.initials: WH
authors.lastname: Allum
authors.affiliation: Section of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Cerfolio
authors.affiliation: Hospital Universitario del Mar, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pera
authors.affiliation: University of Newcastle upon Tyne, Newcastle, United Kingdom.
authors.forename: S M
authors.initials: SM
authors.lastname: Griffin
authors.affiliation: University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Burger
authors.affiliation: Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: J-F
authors.initials: JF
authors.lastname: Liu
authors.affiliation: Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Allen
authors.affiliation: University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.
authors.forename: S
authors.initials: S
authors.lastname: Law
authors.affiliation: University of Rochester, Rochester, New York, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Watson
authors.affiliation: Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: G E
authors.initials: GE
authors.lastname: Darling
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Scott
authors.affiliation: University of Montreal, Montreal, Quebec, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Duranceau
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Denlinger
authors.affiliation: Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Schipper
authors.affiliation: University Ziekenhuizen Leuven, Leuven, Belgium.
authors.forename: T E M R
authors.initials: TE
authors.lastname: Lerut
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Orringer
authors.affiliation: University of Miami, Miami, Florida, USA.
authors.forename: H
authors.initials: H
authors.lastname: Ishwaran
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: C
authors.initials: C
authors.lastname: Apperson-Hansen
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: DiPaola
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Semple
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Blackstone
mesh_terms: D055011:Ablation Techniques / Q000401:mortality*; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D000070516:Intersectoral Collaboration; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000401:mortality*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods
keywords: cancer staging; decision-making; esophagectomy; prognostication; survival