24. A NOVEL TUMOR STAGING SYSTEM INCORPORATING CN STATUS FOR STRATIFYING EARLY STAGE ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS AFTER TRIMODAL THERAPY

Abstract

Abstract Backgrounds The aim of this study is to investigate the prognostic value of cN status for early stage esophageal squamous cell carcinoma (ESCC) patients after neoadjuvant chemoradiotherapy (nCRT) and construct a new staging model for individual survival prediction. Methods Patients from West China Hospital and Nanjing Jinling Hospital were included for training and validation, respectively. Patients with ESCC who underwent nCRT and esophagectomy were included in this study. Prognostic factors were investigated in patients with ypT0–3N0M0 using survival analysis and Cox regression model. Results For patients with ypI stage, cN status was a significant prognostic factor. The patients with cN1–3 yielded significantly worse OS (p = 0.014) and DFS (p = 0.008) compared with patients with cN0. However, for patients with ypII stage, cN status was not a significant prognostic factor (OS: p = 0.100 and DFS: p = 0.110). Cox regression analysis showed that only cN status was an independent prognostic factor for both OS (p = 0.030) and DFS (p = 0.019) in patients with stage ypI. A new staging model was established based on ypTNM stage and cN status by precisely stratifying ypI ESCC patients. Conclusion We constructed a new staging system based on ypTNM stage and cN status to precisely stratify the patients with ypI stage. Our new ypTNM-cN staging system provides new insights for classifying stage ypI ESCC and shows reliable classification efficacy for all ESCC patients after nCRT and surgery.