Modified Staging Classification of Gallbladder Carcinoma on the Basis of the 8th Edition of American Joint Commission on Cancer (AJCC) Staging System

Abstract Background The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for gallbladder carcinoma (GBC) came into force since 2018. However, the prognostic precision of this staging system has not been properly assessed. This study aimed to evaluate the latest staging system and suggest modifications to improve its prognostic precision. Methods Data of patients with GBC was included from the Surveillance, Epidemiology and End Results (SEER) database (2004–2015) and multicenter database (2010–2017). Baseline clinicopathologic characteristics were recorded including age, sex, race, grade, T category, N category, M category and stage. The Kaplan-Meier method was used to plot survival functions. The prediction power of the AJCC 8th edition and its modified version were evaluated using the concordance index (C-index). Results A total of 2779 GBC patients were included in the SEER database and 591 were collected from multicenter database. While no significant difference in survival of patients was observed between stages IVA and IVB using the 8th AJCC staging system (p > 0.05), the prognosis of stage IIIA showed a slightly better outcome than stage IIIB (p = 0.046) in the SEER database. In the multicenter database, there was no significant difference between stage IIIA and stage IIIB (p > 0.05). Similarly, no significant difference in the survival of patients between stages IIIA and IIIB was observed when M0 patients with at least 6 lymph nodes (LNs) were analyzed (p > 0.05) for both SEER and multicenter database. On the other hand, a modified staging system was able to stratify patients from stage IIIA, stage IIIB and stage IV (p < 0.001). For the SEER database, the C-indexes of 8th AJCC staging system and that of its modified version were 0.709 and 0.742, respectively. For the multicenter database, the C-index of 8th AJCC staging system and that of our modified version were 0.635 and 0.679, respectively. Conclusions The modified 8th staging system proposed in this study can improve the prognostic precision of the 8th AJCC staging system for GBC. We therefore suggest including these modifications in the next update of AJCC staging system for GBC.

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Prognostic value of subclassification (pT2 stage) of pathologically organ-confined prostate cancer: Confirmation of the changes introduced in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2018.3.191 ◽

2018 ◽

Vol 90 (3) ◽

pp. 191-194 ◽

Cited By ~ 2

Author(s):

Hugo Pontes Antunes ◽

Belmiro Parada ◽

João Carvalho ◽

Miguel Eliseu ◽

Roberto Jarimba ◽

...

Keyword(s):

Prostate Cancer ◽

Specific Antigen ◽

Staging System ◽

Distant Metastases ◽

Grade Group ◽

Pathological Evaluation ◽

Ajcc Staging System ◽

Oncological Results ◽

Ajcc Staging ◽

8Th Edition

Objective: The last edition of the AJCC staging system eliminated the pT2 subclassification of prostate cancer (PCa). Our objective was to evaluate the association of pT2 subclassification with the oncological results of patients with PCa who underwent radical prostatectomy (RP). Material and methods: We evaluated 367 patients who underwent RP between 2009 and 2016, with pT2 disease in the final pathological evaluation. We assessed differences in rates of biochemical recurrence (BCR), metastasis and mortality between T2 substages (pT2a/b vs pT2c). Results: Fifty-three (14.4%) patients presented pT2a/b disease and 314 (85.6%) pT2c disease. The mean follow-up time was 4.9 ± 2.6 years. Grade group scores (p = 0.1) and prostate specific antigen (PSA) (p = 0.2) did not differed between pT2 substages. The rate of BCR in pT2a/b and pT2c patients was 11.3% and 18.2%, respectively (p = 0.2). Five (9.4%) patients with pT2a/b and 45 (14.3%) with pT2c substage underwent salvage radiotherapy (p = 0.3). The rate of positive surgical margins did not differ between groups (p = 0.2). Seven (2.2%) patients with pT2c had lymph nodes or distant metastases. The overall survival was 92.5% and 93.6% in pT2a/b and pT2c, respectively (p = 0.2). Conclusion: Our results are in accordance with the changes introduced in the 8th edition of the AJCC staging system in which the pT2 subclassification was eliminated.

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Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Oncotarget ◽

10.18632/oncotarget.19829 ◽

2017 ◽

Vol 8 (41) ◽

pp. 70586-70594 ◽

Cited By ~ 10

Author(s):

Min Kang ◽

Pingting Zhou ◽

Guisheng Li ◽

Haolin Yan ◽

Guosheng Feng ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Intensity Modulated Radiotherapy ◽

Staging System ◽

Intensity Modulated ◽

Ajcc Staging System ◽

Ajcc Staging ◽

8Th Edition

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The Prognostic Value of the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging System in HER2- Enriched Subtype Breast Cancer, a Retrospective Analysis

Anticancer Research ◽

10.21873/anticanres.11862 ◽

2017 ◽

Vol 37 (8) ◽

Cited By ~ 1

Keyword(s):

Breast Cancer ◽

Retrospective Analysis ◽

Prognostic Value ◽

Staging System ◽

American Joint Committee ◽

Ajcc Staging System ◽

Ajcc Staging ◽

8Th Edition

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A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-05979-9 ◽

2020 ◽

Vol 277 (9) ◽

pp. 2407-2412 ◽

Cited By ~ 1

Author(s):

Piotr Machczyński ◽

Ewa Majchrzak ◽

Patryk Niewinski ◽

Joanna Marchlewska ◽

Wojciech Golusiński

Keyword(s):

Oropharyngeal Cancer ◽

Staging System ◽

Cancer Staging ◽

Nodal Metastasis ◽

Clinical Staging ◽

Previous Edition ◽

Hpv Status ◽

Ajcc Staging System ◽

Ajcc Staging ◽

8Th Edition

Abstract Background The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has increased substantially in recent decades, particularly p16-positive human papillomavirus (HPV)-related OPSCC, which has risen by 50% in western countries. HPV-positivity is the most favourable non-anatomic predictor of oropharyngeal cancer outcomes, which underscores the importance of incorporating this variable into the cancer staging system. Methods In the present article, we review the differences between the 7th and 8th editions of the AJCC staging system, with particular focus on the role of HPV-positivity in patients with head and neck cancer. Results In the previous edition (7th edition) of the AJCC/UICC manual, HPV status and its correlation with nodal metastasis were not considered, thereby leading to incorrect lymph node (N) staging and, potentially, inadequate treatment and worse outcomes. The 8th edition of the AJCC manual addresses these issues, providing more accurate discrimination between groups and better risk stratification in patients with HPV-positive OPSCC. In the future, additional adjustments are likely to be needed, such as unification of the pathological and clinical staging models. Conclusions The new staging system is substantially more accurate than the previous system and should be widely adopted in routine clinical practice.

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