scholarly journals Tumor infiltrating lymphocyte stratification of prognostic staging of early-stage triple negative breast cancer

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Sherene Loi ◽  
Roberto Salgado ◽  
Sylvia Adams ◽  
Giancarlo Pruneri ◽  
Prudence A. Francis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Early Stage ◽  
Staging System ◽  
Cancer Staging ◽  
Pooled Analysis ◽  
Tnm Staging ◽  
Adjuvant Setting ◽  
Ajcc Staging System ◽  
Ajcc Staging

AbstractThe importance of integrating biomarkers into the TNM staging has been emphasized in the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging system. In a pooled analysis of 2148 TNBC-patients in the adjuvant setting, TILs are found to strongly up and downstage traditional pathological-staging in the Pathological and Clinical Prognostic Stage Groups from the AJJC 8th edition Cancer Staging System. This suggest that clinical and research studies on TNBC should take TILs into account in addition to stage, as for example patients with stage II TNBC and high TILs have a better outcome than patients with stage I and low TILs.

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

2020 ◽  
Vol 277 (9) ◽  
pp. 2407-2412 ◽  
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.

Changes in the 2003 American Joint Committee on Cancer Staging for Breast Cancer Dramatically Affect Stage-Specific Survival

2003 ◽  
Vol 21 (17) ◽  
pp. 3244-3248 ◽  
Author(s):  
Wendy A. Woodward ◽  
Eric A. Strom ◽  
Susan L. Tucker ◽  
Marsha D. McNeese ◽  
George H. Perkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Staging System ◽  
Stage Ii ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
American Joint Committee ◽  
Number Of Patients ◽  
Ajcc Staging System ◽  
Ajcc Staging

Purpose: To evaluate how implementation of the 2003 American Joint Committee on Cancer (AJCC) staging system will affect stage-specific survival of breast cancer patients. Patients and Methods: Records of 1,350 patients treated on sequential institutional protocols with mastectomy and adjuvant doxorubicin-based chemotherapy were reviewed. Pathologic stage was assigned retrospectively according to the 1988 and the 2003 AJCC staging criteria. Overall stage-specific survival (OS) was calculated using the Kaplan-Meier method, and hypothetical differences were compared by the log-rank test. Results: Six hundred five of 1,087 patients with stage II disease according to the 1988 classification system had stage II disease according to the 2003 system. The 10-year OS for patients with stage II disease was significantly improved using the 2003 system (76% [2003] v 65% [1988]; P < .0001). Two hundred eighty-nine of 633 patients with stage IIb disease using the 1988 system were stage IIb with the 2003 system, and 10-year OS was 58% (1988) versus 70% (2003; P = .003). The number of patients with stage III disease increased from 207 (1988) to 443 (2003), and the 10-year OS changed from 45% (1988) to 50% (2003; P = .077). Most of this difference resulted from changes within stage IIIa: OS, 45% (1988) versus 59% (2003; P < .0001). Conclusion: Stage reclassification using the new AJCC staging system for breast cancer will result in significant changes in reported outcome by stage. It is imperative that careful attention is devoted to this effect so that accurate conclusions regarding the efficacy of new treatment strategies can be drawn.

scholarly journals Novel Staging System for Predicting Disease-Specific Survival in Patients With Breast Cancer Treated With Surgery As the First Intervention: Time to Modify the Current American Joint Committee on Cancer Staging System

2011 ◽  
Vol 29 (35) ◽  
pp. 4654-4661 ◽  
Author(s):  
Min Yi ◽  
Elizabeth A. Mittendorf ◽  
Janice N. Cormier ◽  
Thomas A. Buchholz ◽  
Karl Bilimoria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Validation Cohort ◽  
External Validation ◽  
Staging System ◽  
Cancer Staging ◽  
Disease Specific Survival ◽  
Biologic Markers ◽  
Ajcc Staging ◽  
Disease Specific ◽  
Er Status

Purpose American Joint Committee on Cancer (AJCC) staging is used to determine breast cancer prognosis, yet patient survival within each stage shows wide variation. We hypothesized that differences in biology influence this variation and that addition of biologic markers to AJCC staging improves determination of prognosis. Patients and Methods We identified a cohort of 3,728 patients who underwent surgery as the first intervention between 1997 and 2006. A Cox proportional hazards model, with backward stepwise exclusion of factors and stratification on pathologic stage (PS), was used to test the significance of adding grade (G), lymphovascular invasion (L), estrogen receptor (ER) status (E), progesterone receptor (PR) status, combined ER and PR status (EP), or combined ER, PR, and human epidermal growth factor receptor 2 status (M). We assigned values of 0 to 2 to these disease-specific survival (DSS) –associated factors and assessed six different staging systems: PS, PS + G, PS + G L, PS + G E, PS + G EP, and PS + G M. We compared 5-year DSS rates, Akaike's information criterion (AIC), and Harrell's concordance index (C-index) between systems. Surveillance, Epidemiology, and End Results data were used as the external validation cohort (n = 26,711). Results Median follow-up was 6.5 years, and 5-year DSS rate was 97.4%. The PS + G E status staging system was most precise, with a low AIC (1,931.9) and the highest C-index (0.80). PS + G E status was confirmed to stratify outcomes in internal bootstrapping samples and the external validation cohort. Conclusion Our results validate an improved breast cancer staging system that incorporates grade and ER status. We recommend that biologic markers be incorporated into revised versions of the AJCC staging system.

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 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.

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