scholarly journals Reply to Improving the survival of patients with American Joint Committee on Cancer stage III and IV melanoma

Cancer ◽  
2018 ◽  
Vol 124 (10) ◽  
pp. 2254-2255
Author(s):  
Sarah Sloot ◽  
Yian A. Chen ◽  
Xiuhua Zhao ◽  
Jamie L. Weber ◽  
Jacob J. Benedict ◽  
...  
Keyword(s):  
Stage Iii ◽  
Cancer Stage ◽  
American Joint Committee

Evaluation of the prognostic significance of serum galectin-3 in American Joint Committee on Cancer stage III and stage IV melanoma patients

2009 ◽  
Vol 19 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Pierre Vereecken ◽  
Ahmad Awada ◽  
Stefan Suciu ◽  
Gilberto Castro ◽  
Renato Morandini ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Stage Iv ◽  
Stage Iii ◽  
Cancer Stage ◽  
American Joint Committee ◽  
Galectin 3 ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

scholarly journals Improving the survival of patients with American Joint Committee on Cancer stage III and IV melanoma

Cancer ◽  
2018 ◽  
Vol 124 (10) ◽  
pp. 2253-2253
Author(s):  
Steven Lehrer ◽  
Peter H. Rheinstein ◽  
Kenneth E. Rosenzweig
Keyword(s):  
Stage Iii ◽  
Cancer Stage ◽  
American Joint Committee

scholarly journals Late Diagnosis among patients with Prostate Cancer at the Uganda Cancer Institute: A retrospective cohort study

2019 ◽  
Author(s):  
Nelson Bunani ◽  
Angela Nakanwagi Kisakye ◽  
Aloysius Ssennyonjo ◽  
Fred Nuwaha
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Prostate Specific Antigen ◽  
Retrospective Cohort ◽  
Specific Antigen ◽  
Late Diagnosis ◽  
Stage Iii ◽  
Cancer Stage ◽  
Initial Symptoms ◽  
Time To Diagnosis

Abstract Background Late diagnosis of prostate cancer is common in Uganda and elsewhere. Diagnosis in advanced stages is associated with high mortality, morbidity and low quality of life. We estimated time taken from perception of symptoms attributable to prostate cancer to biopsy among patients with prostate cancer at the Uganda Cancer Institute (UCI) and the associated factors. Methods We conducted a retrospective cohort analysis of records of 280 patients with histologically confirmed diagnosis of prostate cancer at UCI from January 2016 to December 2017. Time to diagnosis was obtained from the difference between the approximate date of onset of initial symptoms and date when a biopsy was taken. Late diagnosis was that when an individual was diagnosed with prostate cancer stage III or IV whereas stages I and II were classified as early. We used modified poisson regression to assess factors associated with timing of diagnosis among patients. Results The median time from first perceived symptoms to biopsy for prostate cancer patients was 12 (IQR5-24) months and 76% were diagnosed after 4 months of symptoms. Median age at time of diagnosis of patients was 70 (IQR66-74.5) years and at least 50% were aged between 65-74 years. About 81.8% of the patients were diagnosed late; of which 35.7% were in stage III and 46.1% were in stage IV. Nearly all patients presented with raised prostate specific antigen with median prostate specific antigen of 100.2 (IQR36.02-350) ng/ml of blood at the time of admission. In adjusted analysis, a patients whose biopsies were taken before 5 months of recognising symptoms were two times as likely to have cancer stage I and II compared to those patients in whom the biopsies were taken after 4 months. Conclusion More than three in four patients were diagnosed late. Taking a biopsy after 4 months of initiation of symptoms was partially responsible for the delay. To improve time to diagnosis, communities should be educated about symptoms of prostate cancer and advised to seek health care early. Health care workers should be sensitised to suspect prostate cancer among patients to allow timely referral for appropriate specialised assessment and management.

scholarly journals Melanoma Prognosis: Accuracy of the American Joint Committee on Cancer Staging Manual Eighth Edition

2020 ◽  
Vol 112 (9) ◽  
pp. 921-928 ◽  
Author(s):  
Shirin Bajaj ◽  
Douglas Donnelly ◽  
Melissa Call ◽  
Paul Johannet ◽  
Una Moran ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Statistical Tests ◽  
Area Under The Curve ◽  
Cancer Staging ◽  
Stage I ◽  
Stage Iii ◽  
Prognostic Accuracy ◽  
American Joint Committee ◽  
Melanoma Prognosis ◽  
Eighth Edition

Abstract Background The American Joint Committee on Cancer (AJCC) maintains that the eighth edition of its Staging Manual (AJCC8) has improved accuracy compared with the seventh (AJCC7). However, there are concerns that implementation may disrupt analysis of active clinical trials for stage III patients. We used an independent cohort of melanoma patients to test the extent to which AJCC8 has improved prognostic accuracy compared with AJCC7. Methods We analyzed a cohort of 1315 prospectively enrolled patients. We assessed primary tumor and nodal classification of stage I–III patients using AJCC7 and AJCC8 to assign disease stages at diagnosis. We compared recurrence-free (RFS) and overall survival (OS) using Kaplan-Meier curves and log-rank tests. We then compared concordance indices of discriminatory prognostic ability and area under the curve of 5-year survival to predict RFS and OS. All statistical tests were two-sided. Results Stage IIC patients continued to have worse outcomes than stage IIIA patients, with a 5-year RFS of 26.5% (95% confidence interval [CI] = 12.8% to 55.1%) vs 56.0% (95% CI = 37.0% to 84.7%) by AJCC8 (P = .002). For stage I, removing mitotic index as a T classification factor decreased its prognostic value, although not statistically significantly (RFS concordance index [C-index] = 0.63, 95% CI = 0.56 to 0.69; to 0.56, 95% CI = 0.49 to 0.63, P = .07; OS C-index = 0.48, 95% CI = 0.38 to 0.58; to 0.48, 95% CI = 0.41 to 0.56, P = .90). For stage II, prognostication remained constant (RFS C-index = 0.65, 95% CI = 0.57 to 0.72; OS C-index = 0.61, 95% CI = 0.50 to 0.72), and for stage III, AJCC8 yielded statistically significantly enhanced prognostication for RFS (C-index = 0.65, 95% CI = 0.60 to 0.70; to 0.70, 95% CI = 0.66 to 0.75, P = .01). Conclusions Compared with AJCC7, we demonstrate that AJCC8 enables more accurate prognosis for patients with stage III melanoma. Restaging a large cohort of patients can enhance the analysis of active clinical trials.

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