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Title: Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy

Abstract

Background: The 7th edition of the American Joint Committee on Cancer staging system does not include lymph node size in the guidelines for staging patients with esophageal cancer. The objectives of this study were to determine the prognostic impact of the maximum metastatic lymph node diameter (ND) on survival and to develop and validate a new staging system for patients with esophageal squamous cell cancer who were treated with definitive chemoradiotherapy (CRT). Methods: Information on 402 patients with esophageal cancer undergoing CRT at two institutions was reviewed. Univariate and multivariate analyses of data from one institution were used to assess the impact of clinical factors on survival, and recursive partitioning analysis was performed to develop the new staging classification. To assess its clinical utility, the new classification was validated using data from the second institution. Results: By multivariate analysis, gender, T, N, and ND stages were independently and significantly associated with survival (p < 0.05). The resulting new staging classification was based on the T and ND. The four new stages led to good separation of survival curves in both the developmental and validation datasets (p < 0.05). Conclusions: Our results showed that lymph node size is a strong independentmore » prognostic factor and that the new staging system, which incorporated lymph node size, provided good prognostic power, and discriminated effectively for patients with esophageal cancer undergoing CRT.« less

Authors:
 [1];  [2];  [2];  [3];  [4]; ; ;  [3]; ;  [1];  [3];  [1]
  1. Department of Radiology, Kansai Medical University, Hirakata (Japan)
  2. (Japan)
  3. Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya (Japan)
  4. Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya (Japan)
Publication Date:
OSTI Identifier:
22149597
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CLASSIFICATION; COMBINED THERAPY; DATASETS; ESOPHAGUS; LYMPH NODES; METASTASES; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; RECOMMENDATIONS; SURVIVAL CURVES

Citation Formats

Nomura, Motoo, E-mail: excell@hkg.odn.ne.jp, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Shitara, Kohei, Kodaira, Takeshi, Kondoh, Chihiro, Takahari, Daisuke, Ura, Takashi, Kojima, Hiroyuki, Kamata, Minoru, Muro, Kei, and Sawada, Satoshi. Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.069.
Nomura, Motoo, E-mail: excell@hkg.odn.ne.jp, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Shitara, Kohei, Kodaira, Takeshi, Kondoh, Chihiro, Takahari, Daisuke, Ura, Takashi, Kojima, Hiroyuki, Kamata, Minoru, Muro, Kei, & Sawada, Satoshi. Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy. United States. doi:10.1016/J.IJROBP.2011.12.069.
Nomura, Motoo, E-mail: excell@hkg.odn.ne.jp, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Shitara, Kohei, Kodaira, Takeshi, Kondoh, Chihiro, Takahari, Daisuke, Ura, Takashi, Kojima, Hiroyuki, Kamata, Minoru, Muro, Kei, and Sawada, Satoshi. Thu . "Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy". United States. doi:10.1016/J.IJROBP.2011.12.069.
@article{osti_22149597,
title = {Recursive Partitioning Analysis for New Classification of Patients With Esophageal Cancer Treated by Chemoradiotherapy},
author = {Nomura, Motoo, E-mail: excell@hkg.odn.ne.jp and Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya and Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya and Shitara, Kohei and Kodaira, Takeshi and Kondoh, Chihiro and Takahari, Daisuke and Ura, Takashi and Kojima, Hiroyuki and Kamata, Minoru and Muro, Kei and Sawada, Satoshi},
abstractNote = {Background: The 7th edition of the American Joint Committee on Cancer staging system does not include lymph node size in the guidelines for staging patients with esophageal cancer. The objectives of this study were to determine the prognostic impact of the maximum metastatic lymph node diameter (ND) on survival and to develop and validate a new staging system for patients with esophageal squamous cell cancer who were treated with definitive chemoradiotherapy (CRT). Methods: Information on 402 patients with esophageal cancer undergoing CRT at two institutions was reviewed. Univariate and multivariate analyses of data from one institution were used to assess the impact of clinical factors on survival, and recursive partitioning analysis was performed to develop the new staging classification. To assess its clinical utility, the new classification was validated using data from the second institution. Results: By multivariate analysis, gender, T, N, and ND stages were independently and significantly associated with survival (p < 0.05). The resulting new staging classification was based on the T and ND. The four new stages led to good separation of survival curves in both the developmental and validation datasets (p < 0.05). Conclusions: Our results showed that lymph node size is a strong independent prognostic factor and that the new staging system, which incorporated lymph node size, provided good prognostic power, and discriminated effectively for patients with esophageal cancer undergoing CRT.},
doi = {10.1016/J.IJROBP.2011.12.069},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}