Comprehensive Registry of Esophageal Cancer in Japan, 2009

1We deeply appreciate the great contributions of many physicians in the registry of esophageal cancer cases. The Comprehensive Registry of Esophageal Cancer in Japan, 2009 was published here, despite some delay. The registry complies with the Act for the Protection of Personal Information. The encryption with a HASH function is used for ‘‘anonymity in an unlinkable fashion’’.

2We briefly summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2009. Japanese Classification of Esophageal Cancer 10th and UICC TNM Classification 6th were used for cancer staging according to the subjected year. A total of 6260 cases were registered from 276 institutions in Japan. Tumor locations were cervical: 4.4 %, upper thoracic: 11.9 %, middle thoracic: 48.0 %, lower thoracic: 27.7 % and EG junction: 6.6 %. Superficial carcinomas (Tis, T1a, T1b) were 36.7 %. As for the histologic type of biopsy specimens, squamous cell carcinoma and adenocarcinoma accounted for 90.5 and 3.8 %, respectively. Regarding clinical results, the 5-year survival rates of patients treated using endoscopic mucosal resection, concurrent chemoradiotherapy, radiotherapy alone, chemotherapy alone, or esophagectomy were 86.2, 27.9, 20.2, 5.8, and 55.9 %, respectively. Esophagectomy was performed in 3844 cases. Concerning the approach used for esophagectomy, 24.9 % of the cases were treated thoracoscopically. The operative mortality (within 30 days after surgery) was 1.01 % and the hospital mortality was 4.76 %.

3We hope that this Comprehensive Registry of Esophageal Cancer in Japan, 2009 will help to improve all aspects of the diagnosis and treatment of esophageal cancer in Japan.

4Clinical factors of esophageal cancer patients treated in 2009Institution-registered cases in 2009Patient BackgroundTable1Age and genderTable2Primary treatmentTable3Tumor locationTable4Histologic types of biopsy specimensTable5Depth of tumor invasion, cT (UICC TNM 6th)Table6Lymph node metastasis, cN (UICC TNM 6th)Table7Distant metastasis, cM (UICC TNM 6th)Table8Clinical stage (UICC TNM 6th)Results of endoscopically treated patients in 2009Table9Details of endoscopic treatmentTable10Complications of EMR/ESDTable11Pathological depth of tumor invasion of EMR/ESD specimensFigure1Survival of patients treated with EMR/ESDFigure2Survival of patients treated with EMR/ESD according to the pathological depth of tumor invasion (pT)Figure3Survival of patients treated with EMR/ESD according to the lymphatic and venous invasionResults in patients treated with chemotherapy and/or radiotherapy in 2009Table12Dose of radiation (non-surgically treated cases)Table13Dose of radiation (surgically treated cases)Figure4Survival of patients treated with chemotherapy and/or radiotherapy (cStage I-IIA)Figure5Survival of patients treated with chemotherapy and/or radiotherapy (cStage IIB-IVB)Results in patients underwent esophagectomy in 2009Table14Treatment modalities of esophagectomyTable15Tumor locationTable16Approaches to tumor resectionTable17Video-assisted surgeryTable18Fields of lymph node dissection according to the location of the tumorTable19Reconstruction routeTable20Organs used for reconstructionTable21Histological classificationTable22Depth of tumor invasion, pT (JES 10th)Table23Pathological grading of lymph node metastasis, pN (JES 10th)Table24Numbers of the metastatic nodesTable25Pathological findings of distant organ metastasis, pM (JES 10th)Table26Residual tumor, RTable27Causes of deathFigure6Survival of patients who underwent esophagectomyFigure7Survival of patients who underwent esophagectomy according to clinical stage (JES TNM 10th)Figure8Survival of patients who underwent esophagectomy according to clinical stage (UICC TNM 6th)Figure9Survival of patients who underwent esophagectomy according to the depth of tumor invasion (JES 10th: pT)Figure10Survival of patients who underwent esophagectomy according to the depth of tumor invasion (UICC TNM 6th: pT)Figure11Survival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th: pN)Figure12Survival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 6th: pN)Figure13Survival of patients who underwent esophagectomy according to number of metastatic nodesFigure14Survival of patients who underwent esophagectomy according to pathological stage (JES 10th)Figure15Survival of patients who underwent esophagectomy according to pathological stage (UICC TNM 6th)Figure16Survival of patients who underwent esophagectomy according to residual tumor (R)

5Clinical factors of esophageal cancer patients treated in 2009Institution-registered cases in 2009Patient BackgroundTable1Age and genderTable2Primary treatmentTable3Tumor locationTable4Histologic types of biopsy specimensTable5Depth of tumor invasion, cT (UICC TNM 6th)Table6Lymph node metastasis, cN (UICC TNM 6th)Table7Distant metastasis, cM (UICC TNM 6th)Table8Clinical stage (UICC TNM 6th)

6Institution-registered cases in 2009

7Patient BackgroundTable1Age and genderTable2Primary treatmentTable3Tumor locationTable4Histologic types of biopsy specimensTable5Depth of tumor invasion, cT (UICC TNM 6th)Table6Lymph node metastasis, cN (UICC TNM 6th)Table7Distant metastasis, cM (UICC TNM 6th)Table8Clinical stage (UICC TNM 6th)

8Table1Age and gender

9Table2Primary treatment

10Table3Tumor location

11Table4Histologic types of biopsy specimens

12Table5Depth of tumor invasion, cT (UICC TNM 6th)

13Table6Lymph node metastasis, cN (UICC TNM 6th)

14Table7Distant metastasis, cM (UICC TNM 6th)

15Table8Clinical stage (UICC TNM 6th)

16Results of endoscopically treated patients in 2009Table9Details of endoscopic treatmentTable10Complications of EMR/ESDTable11Pathological depth of tumor invasion of EMR/ESD specimensFigure1Survival of patients treated with EMR/ESDFigure2Survival of patients treated with EMR/ESD according to the pathological depth of tumor invasion (pT)Figure3Survival of patients treated with EMR/ESD according to the lymphatic and venous invasion

17Table9Details of endoscopic treatment

18Table10Complications of EMR/ESD

19Table11Pathological depth of tumor invasion of EMR/ESD specimens

20Figure1Survival of patients treated with EMR/ESD

21Figure2Survival of patients treated with EMR/ESD according to the pathological depth of tumor invasion (pT)

22Figure3Survival of patients treated with EMR/ESD according to the lymphatic and venous invasion

23Results in patients treated with chemotherapy and/or radiotherapy in 2009Table12Dose of radiation (non-surgically treated cases)Table13Dose of radiation (surgically treated cases)Figure4Survival of patients treated with chemotherapy and/or radiotherapy (cStage I-IIA)Figure5Survival of patients treated with chemotherapy and/or radiotherapy (cStage IIB-IVB)

24Table12Dose of radiation (non-surgically treated cases)

25Table13Dose of radiation (surgically treated cases)

26Figure4Survival of patients treated with chemotherapy and/or radiotherapy (cStage I-IIA)

27Figure5Survival of patients treated with chemotherapy and/or radiotherapy (cStage IIB-IVB)

28Results in patients underwent esophagectomy in 2009Table14Treatment modalities of esophagectomyTable15Tumor locationTable16Approaches to tumor resectionTable17Video-assisted surgeryTable18Fields of lymph node dissection according to the location of the tumorTable19Reconstruction routeTable20Organs used for reconstructionTable21Histological classificationTable22Depth of tumor invasion, pT (JES 10th)Table23Pathological grading of lymph node metastasis, pN (JES 10th)Table24Numbers of the metastatic nodesTable25Pathological findings of distant organ metastasis, pM (JES 10th)Table26Residual tumor, RTable27Causes of deathFigure6Survival of patients who underwent esophagectomyFigure7Survival of patients who underwent esophagectomy according to clinical stage (JES TNM 10th)Figure8Survival of patients who underwent esophagectomy according to clinical stage (UICC TNM 6th)Figure9Survival of patients who underwent esophagectomy according to the depth of tumor invasion (JES 10th: pT)Figure10Survival of patients who underwent esophagectomy according to the depth of tumor invasion (UICC TNM 6th: pT)Figure11Survival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th: pN)Figure12Survival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 6th: pN)Figure13Survival of patients who underwent esophagectomy according to number of metastatic nodesFigure14Survival of patients who underwent esophagectomy according to pathological stage (JES 10th)Figure15Survival of patients who underwent esophagectomy according to pathological stage (UICC TNM 6th)Figure16Survival of patients who underwent esophagectomy according to residual tumor (R)

29Table14Treatment modalities of esophagectomy

30Table15Tumor location

31Table16Approaches to tumor resection

32Table17Video-assisted surgery

33Table18Fields of lymph node dissection according to the location of the tumor

34Table19Reconstruction route

35Table20Organs used for reconstruction

36Table21Histological classification

37Table22Depth of tumor invasion, pT (JES 10th)

38Table23Pathological grading of lymph node metastasis, pN (JES 10th)

39Table24Numbers of the metastatic nodes

40Table25Pathological findings of distant organ metastasis, pM (JES 10th)

41Table26Residual tumor, R

42Table27Causes of death

43Figure6Survival of patients who underwent esophagectomy

44Figure7Survival of patients who underwent esophagectomy according to clinical stage (JES TNM 10th)

45Figure8Survival of patients who underwent esophagectomy according to clinical stage (UICC TNM 6th)

46Figure9Survival of patients who underwent esophagectomy according to the depth of tumor invasion (JES 10th: pT)

47Figure10Survival of patients who underwent esophagectomy according to the depth of tumor invasion (UICC TNM 6th: pT)

48Figure11Survival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th: pN)

49Figure12Survival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 6th: pN)

50Figure13Survival of patients who underwent esophagectomy according to number of metastatic nodes

51Figure14Survival of patients who underwent esophagectomy according to pathological stage (JES 10th)

52Figure15Survival of patients who underwent esophagectomy according to pathological stage (UICC TNM 6th)

53Figure16Survival of patients who underwent esophagectomy according to residual tumor (R)