scholarly journals Liver resection for intrahepatic cholangiocarcinoma in AJCC-stage IV: An evaluation of the survival benefit and prognostic accuracy of current AJCC staging system on N and M classification

2016 ◽  
Vol 36 (5) ◽  
pp. 2663-2672 ◽  
Author(s):  
Lei Yuan ◽  
Xianwu Luo ◽  
Xinyuan Lu ◽  
Bin Huang ◽  
Quanyu Cai
Keyword(s):  
Liver Resection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Survival Benefit ◽  
Stage Iv ◽  
Staging System ◽  
Prognostic Accuracy ◽  
Ajcc Stage ◽  
Ajcc Staging System ◽  
Ajcc Staging

Prognostic Accuracy of the Eighth Edition of TNM Classification Compared with the Seventh and Sixth Edition for Perihilar Cholangiocarcinoma

2020 ◽  
Author(s):  
Hans Michael Hau ◽  
Felix Meyer ◽  
Sebastian Rademacher ◽  
Robert Sucher ◽  
Daniel Seehofer
Keyword(s):  
Liver Resection ◽  
Tnm Classification ◽  
Staging System ◽  
Perihilar Cholangiocarcinoma ◽  
7Th Edition ◽  
Prognostic Accuracy ◽  
Staging Systems ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background This study was conducted to evaluate and compare the prognostic value and performance of the 6th, 7th, and 8th editions of the American Joint Committee on Cancer (AJCC) staging system when applied to patients undergoing surgery for perihilar cholangiocarcinoma (PHC). Methods Patients undergoing liver resection with curative intention for PHC between 2002 and 2019 were identified from a prospective database. Histopathological parameters and stage of the PHC were assessed according to the 6th, 7th, and 8th editions of the tumor node metastasis (TNM) classification. The prognostic accuracy between staging systems was compared using the area under the receiver operating characteristic curve (AUC) model. Results Data for a total of 95 patients undergoing liver resection for PHC were analyzed. The median overall survival time was 21 months (95% CI 8.1–33.9), and the 3- and 5-year survival rates were 46.1% and 36.2%, respectively. Staging according to the 8th edition versus the 7th edition resulted in reclassification of 25 patients (26.3%). The log-rank p-values for the 7th and 8th edition were highly statistically significant (p ≤ 0.01) compared to the 6th edition (p = 0.035). The AJCC 8th edition staging system had a slightly better discrimination ability, with an AUC of 0.69 (95% CI: 0.52–0.84) compared to 0.61 (95% CI: 0.51–0.73) for the 7th edition. Multivariate survival analysis revealed male gender, age > 65 years, positive resection margins, presence of distant metastases, poorly tumor differentiation, lymph node involvement such as no caudate lobe resection as independent predictors of poor survival (p < 0.05). Conclusion The newly released 8th edition of the AJCC staging system demonstrated a poor to moderate ability to predict prognosis of patients undergoing liver resection for perihilar cholangiocarcinoma; the result was only slightly better than the previous 7th edition. Further refinements are needed to improve the prognostic ability of the AJCC staging system for perihilar cholangiocarcinoma and to identify other prognostic factors that can potentially improve individual patient prognostication.

A Single-Institution Validation of the AJCC Staging System for Stage IV Melanoma

2008 ◽  
Vol 15 (7) ◽  
pp. 2034-2041 ◽  
Author(s):  
Heather B. Neuman ◽  
Ami Patel ◽  
Nicole Ishill ◽  
Christine Hanlon ◽  
Mary Sue Brady ◽  
...  
Keyword(s):  
Stage Iv ◽  
Staging System ◽  
Single Institution ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
Stage Iv Melanoma

A SEER database analysis of conditional survival for prostate cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14506-14506 ◽  
Author(s):  
J. Y. Luh ◽  
S. J. Wang ◽  
C. D. Fuller ◽  
C. R. Thomas
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Survival Rates ◽  
Stage Iv ◽  
Staging System ◽  
Conditional Survival ◽  
Prognostic Information ◽  
Appreciable Change ◽  
Ajcc Staging System ◽  
Ajcc Staging

14506 Background: Survival probability changes for patients who have already survived one or more years following diagnosis, and is more accurately represented by conditional survival. The specific aims of this study were to determine the 5-year conditional survival rates for prostate cancer patients. Methods: Using the Surveillance, Epidemiology, and End Results (SEER 11) database from the NCI, we analyzed 66,822 prostate cancer patients diagnosed between 1988 and 1994 that were staged using the SEER-modified AJCC staging system (3rd edition). Using the life table method, we computed observed 5-year conditional survival, stratified by stage, age, and race, for patients who had already survived 0 to 5 years after diagnosis. Results: For each category, we compared baseline 5-year observed survival at diagnosis with 5-year observed conditional survival after having already survived 5 years. Survival decreased from 79% to 67% for Stage I, decreased from 80% to 71% for Stage II, decreased from 83% to 75% for Stage III, but increased from 38% to 49% for Stage IV patients. Survival rates did not change for patients <70 years (79–80%), but decreased from 61% to 55% for patients >70 years old. Although blacks (60–62%) had lower survival than whites (69–71%), no race had any appreciable change in their conditional survival for those who had survived 5 years from diagnosis. Conclusions: For prostate cancer patients who have already survived some time after diagnosis, the expected 5-year conditional survival increases for Stage IV patients, but decreases for other stages and for older patients. Conditional survival can provide more accurate longer term prognostic information for prostate cancer patients who have already survived a number of years after diagnosis. No significant financial relationships to disclose.

scholarly journals Validation and Modification of Staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma

2019 ◽  
Author(s):  
Haihong Wang ◽  
Zhenyu Lin ◽  
Guiling Li ◽  
Dejun Zhang ◽  
Dandan Yu ◽  
...  
Keyword(s):  
Stage Iv ◽  
Staging System ◽  
Risk Groups ◽  
Tnm Staging ◽  
7Th Edition ◽  
Staging Systems ◽  
Significant Difference ◽  
Ajcc Staging System ◽  
Poorly Differentiated ◽  
Ajcc Staging

Abstract Background The American Joint Committee on Cancer (AJCC) staging classifications and the European Neuroendocrine Tumor Society (ENETS) are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful TNM staging system for poorly differentiated pancreatic neuroendocrine carcinomas(pNECs). Methods An analysis was performed to evaluate the application of the ENETS, 7th edition (7th) AJCC and 8th edition (8th) AJCC staging classifications using the Surveillance, Epidemiology, and End Results (SEER) registry (N = 568 patients). A modified system was proposed based on analysis of the 7th AJCC classification. Results In multivariable analyses, only the 7th AJCC staging system allocated patients into four different risk groups, compared with the 8th AJCC staging system and ENETS staging system, although there was no significant difference. We modified the staging classification by maintaining the T and M definitions of the 7th AJCC staging and adopting new staging definitions. An increased hazard ratio (HR) of death was also observed from class I to class IV for the modified 7th (m7th) staging system (compared with stage I disease; HR for stage II =1.23, 95% confidence interval (CI)= 0.73-2.06, P =0.44; HR for stage III =2.20, 95% CI =1.06-4.56, P=0.03; HR for stage IV =4.95, 95% CI =3.20-7.65, P < 0.001).The concordance index (C-index) was higher for local disease with the m7th AJCC staging system than with the 7th AJCC staging system. Conclusions The m7th AJCC staging system for pNECs proposed in this study provides improvements and may be assessed for potential adoption in the next edition.

scholarly journals The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

2019 ◽  
Author(s):  
Weiwei Sheng ◽  
Ming Dong ◽  
Guosen Wang ◽  
Xiaoyang Shi ◽  
Wei Gao ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tumor Size ◽  
Pancreatic Head ◽  
Staging System ◽  
Multicenter Cohort Study ◽  
Ajcc Stage ◽  
Multicenter Cohort ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8 th AJCC stage) that was just applied in clinical practice in 2018. Methods : 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size ( P <0.001), T stage (T1+T2 vs T3+T4, P =0.003), frequent postoperative liver metastasis (PLM) ( P =0.002) and 8 th AJCC stage (IA to VI, P <0.001; I+II vs III+IV, P =0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm ( P =0.012), 8 th AJCC stage (III+IV) ( P =0.025) and PLM ( P =0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients ( P =0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis ( P =0.009). In addition to 8 th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8 th AJCC staging system. 8 th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

scholarly journals Validation and Modification of Staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma

2020 ◽  
Author(s):  
Haihong Wang ◽  
Zhenyu Lin ◽  
Guiling Li ◽  
Dejun Zhang ◽  
Dandan Yu ◽  
...  
Keyword(s):  
Stage Iv ◽  
Staging System ◽  
Risk Groups ◽  
Tnm Staging ◽  
7Th Edition ◽  
Staging Systems ◽  
Significant Difference ◽  
Ajcc Staging System ◽  
Poorly Differentiated ◽  
Ajcc Staging

Abstract Background: The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) staging classifications are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful tumor–node–metastasis (TNM) staging system for poorly differentiated pancreatic neuroendocrine carcinomas(pNECs).Methods: An analysis was performed to evaluate the application of the ENETS, 7th edition (7th) AJCC and 8th edition (8th) AJCC staging classifications using the Surveillance, Epidemiology, and End Results (SEER) registry (N = 568 patients), and a modified system based on the analysis of the 7th AJCC classification was proposed Results: In multivariable analyses, only the 7th AJCC staging system allocated patients into four different risk groups, although there was no significant difference. We modified the staging classification by maintaining the T and M definitions of the 7th AJCC staging and adopting new staging definitions. An increased hazard ratio (HR) of death was also observed from class I to class IV for the modified 7th (m7th) staging system (compared with stage I disease; HR for stage II =1.23, 95% confidence interval (CI)= 0.73-2.06, P =0.44; HR for stage III =2.20, 95% CI =1.06-4.56, P=0.03; HR for stage IV =4.95, 95% CI =3.20-7.65, P < 0.001).The concordance index (C-index) was higher for local disease with the m7th AJCC staging system than with the 7th AJCC staging system. Conclusions: The m7th AJCC staging system for pNECs proposed in this study provides improvements and may be assessed for potential adoption in the next edition.

scholarly journals The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study

2019 ◽  
Author(s):  
Weiwei Sheng ◽  
Ming Dong ◽  
Guosen Wang ◽  
Xiaoyang Shi ◽  
Wei Gao ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tumor Size ◽  
Pancreatic Head ◽  
Staging System ◽  
Multicenter Cohort Study ◽  
Ajcc Stage ◽  
Multicenter Cohort ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background: To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8th AJCC stage) that was just applied in clinical practice in 2018. Methods: 351 patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study. Results: Increasing tumor size (P<0.001), T stage (T1+T2 vs T3+T4, P=0.003), frequent postoperative liver metastasis (PLM) (P=0.002) and 8th AJCC stage (IA to VI, P<0.001; I+II vs III+IV, P=0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3cm (P=0.012), 8th AJCC stage (III+IV) (P=0.025) and PLM (P=0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients (P=0.007). Moreover, pbt was an independent unfavorable factor in multivariate analysis (P=0.009). In addition to 8th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients. Conclusion: Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8th AJCC staging system. 8th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.

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