Refining the Nodal Staging for Esophageal Squamous Cell Carcinoma Based on Lymph Node Stations Jun Peng, MD, Wen-Ping Wang, MD, Ting Dong, MD, Jie Cai,

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Refining the Nodal Staging for Esophageal Squamous Cell Carcinoma Based on Lymph Node Stations Jun Peng, MD, Wen-Ping Wang, MD, Ting Dong, MD, Jie Cai, MD, Peng-Zhi Ni, MD, Long-Qi Chen, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 1, Pages 280-286 (January 2016) DOI: 10.1016/j.athoracsur.2015.06.081 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Percentage of patients with examined and positive nodes in each station. The Annals of Thoracic Surgery 2016 101, 280-286DOI: (10.1016/j.athoracsur.2015.06.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Scatter plot of number of metastatic lymph node (LN) stations on x-axis versus Martingale residuals for the 1,351 patients with esophageal squamous cell carcinoma (ESCC). Patients above horizontal line (zero) were at increased risk for death compared with expected risk from Cox proportional hazards regression model. Patients below the horizontal line (zero) were at decreased risk for death compared with expected risk. Curved line represents smoother scatter plot. Curved line crosses horizontal line at 1 metastatic LN station, indicating that this would be best cutoff point to predict death from esophageal carcinoma. Point at which curved line reaches platform is at 4 metastatic LN stations, indicating that this would be another cutoff point. The Annals of Thoracic Surgery 2016 101, 280-286DOI: (10.1016/j.athoracsur.2015.06.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Overall survival by the nodal category of seventh American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging system (N0 versus N1, N2, N3: p < 0.001; N1 versus N2: p = 0.003; N1 versus N3: p = 0.001; N2 versus N3: p = 0.103). (B) Overall survival by revised nodal categories based on number of metastatic lymph node stations (rN0 versus rN1, rN2, rN3: p < 0.001; rN1 versus rN2: p = 0.001; rN1 versus rN3: p < 0.001; rN2 versus rN3: p = 0.001). (C) Overall survival by original seventh AJCC TNM staging system (overall log rank: p < 0.001; stage IIIA versus stage IIIB, p = 0.021; stage IIIA versus stage IIIC, p < 0.001; stage IIIB versus stage IIIC, p = 0.118). (D) Overall survival by the modified TNM staging system (overall log rank: p < 0.001; stage IIIA versus stage IIIB, p = 0.040; stage IIIA versus stage IIIC, p < 0.001; stage IIIB versus stage IIIC, p = 0.007). The Annals of Thoracic Surgery 2016 101, 280-286DOI: (10.1016/j.athoracsur.2015.06.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions