Classification and Staging Systems

  • Giovanni de Manzoni
  • Francesca Steccanella
  • Andrea Zanoni
Part of the Updates in Surgery book series (UPDATESSURG)


An accurate staging system for cancer aims at providing an indication of prognosis that is as accurate as possible. It also aids in treatment planning, the evaluation of treatment results, and the exchange of information between different centers.


Esophageal Cancer Residual Cancer Cell Hypopharyngeal Squamous Cell Carcinoma Accurate Staging System Multiple Ipsilateral Node 


  1. 1.
    Rice TW, Rusch VW, Ishwaran H, Blackstone EH (2010) Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Cancer Staging Manuals. Cancer 116:3763–3773PubMedCrossRefGoogle Scholar
  2. 2.
    Clinical aspects (2008). In: Japanese Society for Esophageal Disease: Japanese classification of Esophageal Cancer, 10th edn. Kanehara & Co., Ltd., TokyoGoogle Scholar
  3. 3.
    Edge SB, Byrd DR, Compton CC, eds. (2010) AJCC Cancer Staging Manual, 7th ed., Springer, New York, NYGoogle Scholar
  4. 4.
    Eguchi T, Nakanishi Y, Shimoda T et al (2006) Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol 19:475–480PubMedCrossRefGoogle Scholar
  5. 5.
    Rice TW, Blackstone EH, Rybicki LA et al (2003) Refining esophageal cancer staging. J Thorac Cardiovasc Surg 125:1103–1113PubMedCrossRefGoogle Scholar
  6. 6.
    Hsu WH, Hsu PK, Hsieh CC et al (2009) The metastatic lymph node number and ratio are independent prognostic factors in esophageal cancer. J Gastrointest Surg 13:1913–1920PubMedCrossRefGoogle Scholar
  7. 7.
    Hu Y, Hu C, Zhang H et al (2010) How does the number of resected lymph nodes influence TNM staging and prognosis for esophageal carcinoma? Ann Surg Oncol 17:784–790PubMedCrossRefGoogle Scholar
  8. 8.
    Altorki NK, Zhou XK, Stiles B et al (2008) Total number of resected lymph nodes predicts survival in esophageal cancer. Ann Surg 248:221–226PubMedCrossRefGoogle Scholar
  9. 9.
    Liu YP, Ma L, Wang SJ et al (2010) Prognostic value of lymph node metastases and lymph node ratio in esophageal squamous cell carcinoma. Eur J Surg Oncol 36:155–159PubMedCrossRefGoogle Scholar
  10. 10.
    Kunisaki C, Akiyama H, Nomura M et al (2005) Developing an appropriate staging system for esophageal carcinoma. J Am Coll Surg 201:884–890PubMedCrossRefGoogle Scholar
  11. 11.
    Hsu PK, Wu YC, Chou TY et al (2010) Comparison of the 6th and 7th editions of the American Joint Committee on Cancer tumor-node-metastasis staging system in patients with resected esophageal carcinoma. Ann Thorac Surg 89:1024–1031PubMedCrossRefGoogle Scholar
  12. 12.
    Hofstetter W, Correa AM, Bekele N et al (2007) Proposed modification of nodal status in AJCC esophageal cancer staging system. Ann Thorac Surg 84:365–373PubMedCrossRefGoogle Scholar
  13. 13.
    Rizk N, Venkatraman E, Park B et al (2006) The prognostic importance of the number of involved lymph nodes in esophageal cancer: implications for revisions of the American Joint Committee on Cancer staging system. J Thorac Cardiovasc Surg 132:1374–1381PubMedCrossRefGoogle Scholar
  14. 14.
    Wijnhoven BP, Tran KT, Esterman A (2007) An evaluation of prognostic factors and tumor staging of resected carcinoma of the esophagus. Ann Surg 245:717–725PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Korst RJ, Kansler AL, Port JL et al (2006) Downstaging of T or N predicts long-term survival after preoperative chemotherapy and radical resection for esophageal carcinoma. Ann Thorac Surg 82:480–484PubMedCrossRefGoogle Scholar
  16. 16.
    Chang F, Deere H, Mahadeva U, George S (2008) Histopathologic examination and reporting of esophageal carcinomas following preoperative neoadjuvant therapy: practical guidelines and current issues. Am J Clin Pathol 129:252–262PubMedCrossRefGoogle Scholar
  17. 17.
    Mandard AM, Dalibard F, Mandard JC et al (1994) Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer 73:2680–2686Google Scholar
  18. 18.
    Schneider PM, Baldus SE, Metzger R et al (2005) Histomorphologic tumor regression and lymph node metastases determine prognosis following neoadjuvant radiochemotherapy for esophageal cancer: implications for response classification. Ann Surg 242:684–692PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Swisher SG, Hofstetter W, Wu TT (2005) Proposed revision of the esophageal cancer staging system to accommodate pathologic response (pP) following preoperative chemoradiation (CRT). Ann Surg 241:810–817PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Verlato G, Zanoni A, Tomezzoli A et al (2010) Response to induction therapy in oesophageal and cardia carcinoma using Mandard tumour regression grade or size of residual foci. Br J Surg 97:719–725PubMedCrossRefGoogle Scholar
  21. 21.
    Tachimori Y, Nagai Y, Kanamori N et al (2011) Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus 24:33–38PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Giovanni de Manzoni
    • 1
  • Francesca Steccanella
  • Andrea Zanoni
  1. 1.Dept. of Surgery, Upper G.I. Surgery DivisionUniversity of VeronaVeronaItaly

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