Evolution of lymph node staging in esophageal squamous cell carcinoma: insights from lymph node metastatic stations

TL;DR

This paper reviews different lymph node staging systems for esophageal cancer, comparing their strengths and weaknesses in guiding treatment.

Contribution

The paper provides a comparative analysis of UICC/AJCC and JES staging systems and highlights emerging trends in China.

Findings

The UICC/AJCC system is simple but lacks anatomical specificity.

The JES system offers detailed regional stratification but requires more clinical expertise.

China is moving toward station-based staging for better preoperative planning.

Abstract

Esophageal squamous cell carcinoma (ESCC) is a globally prevalent malignancy with distinct regional variations, particularly concentrated in East Asia, including China and Japan. The Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) system offers simplicity but lacks emphasis on anatomical specificity, such as upper mediastinal metastases. Conversely, the Japan Esophageal Society (JES) system provides detailed regional stratification, aiding preoperative planning and tailored therapy, though it demands greater clinical expertise. This review evaluates the current state of pathological lymph node staging systems for ESCC, comparing the UICC/AJCC and JES approaches and exploring emerging trends in China toward station-based staging.