Comparison of 6^th and 7^th Editions of AJCC/UICC TNM Staging for Esophageal Cancer Patients Received Radiotherapy

Objective To evaluate the reasonability of the 6^th and 7^th editions of American Joint Committee on Cancer/Union for International Cancer Control(AJCC/UICC) tumor node metastasis(TNM) staging foresophageal carcinoma in radiotherapy and their effect on prognosis. Methods We retrospectively analyzed 265 esophageal carcinoma patients received radiotherapy. In accordance with different definition about location segment in the 6^th and 7^th edition of AJCC/UICC TNM staging for esophageal carcinoma, we analyzed and evaluated the prognosis by univariate and multivariate survival analysis. Results According to the 7^th edition of AJCC/UICC TNM staging for esophageal carcinoma, the number of esophagus primary lesions in cervical, upper, middle and inferior thoracic portion were 46, 76, 83 and 60, respectively, according to the 6th edition, the number were 16, 83, 132 and 34, respectively. All patients were divided into two groups according to the two methods, the consistent group (169 cases) and the difference group (96 cases). In consistent group, the 1-, 2-, 3-year survival rates of patients with esophageal carcinoma in cervical, upper, middle and inferior thoracic portion were 70.6%, 64.7%, 64.7%；84.3%, 57.8%, 53.6%；53.4%, 32.7%, 21.0% and 71.4%, 40.2%, 40.2%, respectively(P=0.001). The difference wasn't signi?cant statistically in the difference group. Multivariate analysis showed that age, the 6th edition of TNM staging and radiation dose were independent factors for the survival. Conclusion The difference of two staging methods on the esophageal carcinoma in cervical, middle and inferior thoracic portion is obvious. The 6th edition of AJCC/UICC TNM staging could better predict the survival. The survival of patients with esophageal carcinoma in cervical and upper thoracic portion after radiotherapy is superior to those in the middle and inferior thoracic portion.