ArticleAnnals of surgery2025
Proposal of New ypStage Grouping System for Esophageal Squamous Cell Carcinoma Patients who Underwent Neoadjuvant Chemoradiotherapy followed by Surgery.
Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Do we need to adapt the American Joint Committee on Cancer staging system after neo-adjuvant treatment in esophageal squamous cell carcinoma?Translational cancer research · 2026Article
- Validation and refinement of the AJCC 8th edition ypStage in esophageal squamous cell carcinoma after neoadjuvant therapy: a large-scale retrospective cohort study.International journal of surgery (London, England) · 2026Article
- A squamous epithelial gene interaction perturbation network index for risk stratification in esophageal squamous cell carcinoma.Journal of Cancer · 2026Article
- Survival impact of adjuvant capecitabine in triple-negative breast cancer Latin American patients with residual disease: a real-world study.Breast cancer research and treatment · 2025Article
- Comment on "Prognostic value of middle paraesophageal lymph node metastasis in patients with pathologic N+ esophageal squamous cell carcinoma".International journal of surgery (London, England) · 2025Article
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12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo propose a new ypTNM grouping system to address these limitations and improve prognostic relevance. SUMMARY BACKGROUND DATA: The current 8th edition of the American Joint Committee on Cancer (AJCC) ypStage system shows unsatisfactory prognostic relevance in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy.
methodsThe study cohort included 501 ESCC patients who received nCRT followed by esophagectomy at the Samsung Medical Center in Korea between 1994 and 2018 (development cohort) and 422 patients treated at Asan Medical Center (validation cohort). Recursive partitioning with a tree-structured regression model was used to develop and validate a new ypStage grouping system.
resultsIn the new ypStage grouping system, ypStage I includes ypT0N0 only; ypStage II includes ypTis-T2N0 or ypT0-T2N1; ypStage III includes ypT3N0-N1; and ypStage IV includes ypT4N0-N1 or ypTanyN2-3. This system adequately addressed the limitations of the existing AJCC classification system, including overlapping and reversal of survival rates. Moreover, the discrimination ability of the new system was higher than that of the existing system [concordance-index (C-index): 61.9%] in the development (C-index: 66.6%) and validation (C-index: 66.0%) cohorts. NRIe was 0.17 [95% confidence interval (CI): 0.09-0.26, P-<0.001) and 0.18 (95% CI: 0.10-0.27, P-<0.001)] in the development and validation cohorts, respectively.
conclusionsThe current study proposes a clear revised version of the 8th edition of the AJCC ypStage grouping system that exhibits superior prognostic stratification in patients with ESCC treated with nCRT followed by esophagectomy.
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