Comparison Of Non-operative Staging And Postoperative Staging Of Esophageal Carcinoma And Analysis Of Prognostic Factors

Objective: To explore the consistency of clinical staging criterion of non-surgical esophageal cancer(the draft)and the postoperative pathological staging of esophageal cancer according to the TNM staging of AJCC / UICC(8th edition)in esophageal cancer,and the value of two staging criteria for prognosis.As well to analyze the prognostic factors in esophageal cancer patients with radical surgery.Methods: one hundred and forty-eight patients who underwent radical surgery diagnosed with esophageal cancer from June 2012 to October 2016 were enrolled.Clinical staging criterion of non-surgical esophageal cancer was performed according to preoperative CT,esophageal barium meal,and so forth.The TNM staging of AJCC / UICC(8th edition)in esophageal cancer was used based on postoperative pathologic diagnosis.Kappa method was used to analyze the consistency of the distribution among the two different stages.The Kaplan-Meier method was applied to analyze the survival of the two stages in terms of the T staging,N staging and TNM staging.The prognostic factors were analyzed by univariate and multivariate analysis.Results:(1)The median survival time was 25 months(1-54 months)in all patients.The survival rate in 1st year,2nd year and 3rd year were 82.0%,51.2%,and 20.5%,respectively.(2)Comparison of preoperative draft T staging and postoperative pathologic T staging in coincidence: a total of 104 patients with T staging matched,the coincidence rate was 70.3%,and Kappa value was0.528;a total of 100 patients with N staging matched,the coincidence rate was67.6%,and Kappa value was 0.470.Both T staging and N staging were in moderate consistency.A total of 90 cases TNM staging matched,the coincidence rate was 60.8%,and Kappa value was 0.402.TNM staging was in moderate consistency,too.(3)The survival curves of T,N and TNM staging in two staging criteria could be separated distinctly,deserving further investigation.(4)The results of multivariate analysis showed that age,UICC T stage,tumor location,pathological type,pathological differentiation,margin,lymph node metastasis and history of drinking were the independent risk factors for esophageal cancer patients with radical surgery.Conclusion: The clinical stage of non-surgical esophageal cancer is consistent with UICC staging,and it is possible to separate the survival curves,which is worthy of further studying.Age,UICC T stage,tumor location,pathological type,pathological differentiation,margin,lymph node metastasis and history of drinking are the independent risk factors for esophageal cancer patients with radical surgery,providing better understanding for prognosis.