Abstract
Purpose: We aim to investigate the current esophageal cancer staging according to the 7th edition TNM classification for esophageal carcinoma proposed by American Joint Committee on Cancer (AJCC) among oncology-related physicians in China.Methods: A specifically-designed 14-item questionnaire was distributed to 366 doctors who were working with esophageal cancer patients. We collected and analyzed the feedbacks and explored the possible associations within different departments, including thoracic surgery, the internal medicine of gastroenterology, oncology, and/ radiotherapy in eight different hospitals from central and southern China.Results: Among all the responses, 31.42% of them were from thoracic surgery department, 40.44% were from oncology and/or radiation therapy and 28.14% were from the internal medicine of gastroenterology, respectively. Surprisingly, in total 66.12% of all the physicians were unaware that the 7th edition of esophageal carcinoma TNM classification was released in 2009; only 21.86 and 16.67% of physicians recognized cervical nodes and celiac nodes as regional lymph nodes. Furthermore, 67.21% physicians didn't know that tumor location, histologic grade, and histopathology were accepted as new prognostic factors in the latest TNM system; and 51.37% physicians could not determine the correct TNM classification of esophagogastric junction cancers. Intriguingly, over 50% of them could still design appropriate perioperative strategies.Conclusions: The 7th edition of the TNM classification for esophageal carcinoma is poorly recognized and understood in central and southern China, which might contribute to the relatively low rates of appropriate perioperative procedures applied for esophageal cancer patients.
Highlights
Esophageal cancer is the eighth most common cancer worldwide with an estimated incidence of 6.5 per 100,000 in 2012 (3.2% of all cancer occurrence), and the sixth most common cause of cancer death with a roughly mortality of 5.7 per 100,000 (4.9% of all cancer-related death)
To obtain the first-hand data regarding current situation of esophageal cancer Staging and perioperative strategies in central and southern China, we carried out this crosssectional study by generating a specific questionnaire
There were no differences between different areas regarding the low awareness of the TNM system, our data suggested that examinees from different academic levels (p = 0.015) or departments (p < 0.01) had significant difference in awareness of the latest TNM staging system
Summary
Esophageal cancer is the eighth most common cancer worldwide with an estimated incidence of 6.5 per 100,000 in 2012 (3.2% of all cancer occurrence), and the sixth most common cause of cancer death with a roughly mortality of 5.7 per 100,000 (4.9% of all cancer-related death). Esophageal cancer is the 5th most common cancer (22.16 per 100,000) and 4th most common cause (16.64 per 100,000) of cancer related death in China [2]; indicating China has a more severe esophageal cancer burden compared to other regions. The prognosis for early stage esophageal cancer patients is significantly superior to that of intermediate and late stage patients. The overall survival of esophageal cancer in China is very low due to the undeveloped early detection of esophageal cancer via endoscopy the majority of patients are diagnosed as the intermediate or late stages [3]. The poor prognosis might be caused by clinicians’ limited knowledge of esophageal cancer, for example, the TNM staging system, which is extremely important for corresponding treatments planning
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