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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2019.01098

The Current Situation of Esophageal Cancer Staging and Perioperative Strategies Determination in Central and Southern China: A Cross Sectional Survey

Di Lu1, Xiguang Liu1, Siyang Feng1, Xiaoying Dong1,  Xiaoshun Shi1, Xiaoshun Shi1, Dingwei Diao1, Hua Wu1, Gang Xiong1, Haofei Wang1, Mei Li1, Shuan Rao1, Daniela Molena2, Abraham J. Wu3 and  Kaican Cai1*
  • 1Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, China
  • 2Department of Surgery, Memorial Sloan Kettering Cancer Center, United States
  • 3Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, United States

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.

Keywords: esophageal cancer, TNM, Perioperative strategies, central and southern China, Current situation

Received: 15 Feb 2019; Accepted: 07 Oct 2019.

Copyright: © 2019 Lu, Liu, Feng, Dong, Shi, Shi, Diao, Wu, Xiong, Wang, Li, Rao, Molena, Wu and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Kaican Cai, Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China,