Dukes' classification as a useful staging system in resectable squamous cell carcinoma of the esophagus

Citation
M. Tachibana et al., Dukes' classification as a useful staging system in resectable squamous cell carcinoma of the esophagus, VIRCHOWS AR, 438(4), 2001, pp. 350-356
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY
ISSN journal
0945-6317 → ACNP
Volume
438
Issue
4
Year of publication
2001
Pages
350 - 356
Database
ISI
SICI code
0945-6317(200104)438:4<350:DCAAUS>2.0.ZU;2-6
Abstract
Dukes' classification for colorectal cancer is simple and has been widely u sed as a valuable prognostic indicator. It has been used as an assessment o f gastric cancer, but it has not been evaluated for esophageal cancer. Of 2 51 patients with primary squamous cell carcinoma of the thoracic esophagus between February 1981 and April 1999, 155 patients underwent esophagectomy with a curative intent. Clinicopathologic characteristics of those 155 pati ents were retrospectively investigated according to the Dukes', tumor node metastasis (TNM) and Japanese staging systems. Dukes' classification showed a clear correlation between tumor stage and survival. The 3-year and 5-yea r survival rates of 64 Dukes' A cases were excellent (97.4% and 93.7%), goo d for 12 Dukes' B (75% and 75%), and poor for 79 Dukes' C (50.5% and 43.4%) , respectively (P <0.05; Dukes' A vs B, P <0.0001; Dukes' A vs C, P <0.10: Dukes' B vs C). TNM stage classification also showed a good correlation bet ween tumor stage and survival, but there were no significant differences be tween stage 0, I and stage IIA cases (P=0.2678) and between stage III and s tage IV cases (P=0.8298), In the Japanese staging system, there were no sig nificant differences among stage 0, stage 1, and stage 2 cases (P=0.4093). Dukes' classification was significantly correlated with tumor size, Borrman n type, histological type, and vessel invasion. Subdivision of Dukes' C acc ording to the number of positive lymph nodes (1-4 vs greater than or equal to5) showed a clearer correlation with survival rather than other subdivisi ons, such as the metastatic lymph node ratio (<1.0 vs >1.0) or the site of lymph node metastasis. Dukes' classification, which incorporates the number of positive lymph nodes, correlates well with tumor progression and provid es a simple useful staging system after curative esophagectomy for esophage al cancer. Dukes' A tumor could be proposed as a criterion of early esophag eal carcinoma.