scholarly journals Modification of the 8th American Joint Committee on Cancer staging system for gallbladder carcinoma to improve prognostic precision

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Jiang ◽  
Bingqing Zhao ◽  
Yongcheng Li ◽  
Dunfeng Qi ◽  
Daxing Wang
Keyword(s):  
Gallbladder Carcinoma ◽  
Staging System ◽  
Stage Iiib ◽  
Seer Database ◽  
Stage Iiia ◽  
American Joint Committee ◽  
Significant Difference ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

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.

scholarly journals The 8th Edition American Joint Committee on Cancer Staging for Hepato-pancreato-biliary Cancer: A Review and Update

2020 ◽  
Author(s):  
Xiaoyan Liao ◽  
Dongwei Zhang
Keyword(s):  
Literature Review ◽  
Staging System ◽  
Cancer Staging ◽  
Biliary Cancer ◽  
7Th Edition ◽  
American Joint Committee ◽  
Scoring Algorithm ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Context.— Cancer staging provides critical information for patients and treating physicians to battle against cancer, predict prognosis, and guide treatment decisions. The American Joint Committee on Cancer (AJCC) staging system uses a tumor, node, metastasis (TNM) scoring algorithm and is the foremost classification system for adult cancers. This system is updated every 6 to 8 years to allow sufficient time for implementation of changes and for relevant examination and discussion of data validating those changes in staging. Objective.— To review the updates in the 8th edition American Joint Committee on Cancer staging system on hepato-pancreato-biliary cancer. Data Sources.— Literature review. Conclusions.— The 8th edition, published in 2016 and implemented on January 1, 2018, has been in use for approximately 2 years. Compared with the 7th edition, some of the changes are quite radical. This review aims to provide a summary of the changes/updates of the 8th edition with focus on hepato-pancreato-biliary cancers, and evaluate its performance through literature review.

scholarly journals A better prognostic stratification for the 8th edition of the AJCC staging system of gastric cancer by incorporating pT4aN0M0 into stage IIIA

2019 ◽  
Vol 29 ◽  
pp. 90-96
Author(s):  
Yongming Chen ◽  
Guanrong Zhang ◽  
Baiwei Zhao ◽  
Chunyu Huang ◽  
Yihong Ling ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Staging System ◽  
Stage Iiia ◽  
Prognostic Stratification ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

scholarly journals Stage migration with the new American Joint Committee on Cancer (AJCC) staging system (8th edition) for differentiated thyroid cancer

Surgery ◽  
2019 ◽  
Vol 165 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Ashok R. Shaha ◽  
Jocelyn C. Migliacci ◽  
Iain J. Nixon ◽  
Laura Y. Wang ◽  
Richard J. Wong ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Staging System ◽  
Stage Migration ◽  
American Joint Committee ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

scholarly journals Survival analysis of patients with stage T2a and T2b perihilar cholangiocarcinoma treated with radical resection

2020 ◽  
Author(s):  
Jian Zhao ◽  
Wei Zhang ◽  
Jun Zhang ◽  
Yi Zhang ◽  
Wenjie Ma ◽  
...  
Keyword(s):  
Cox Regression ◽  
Staging System ◽  
Tnm Staging ◽  
Perihilar Cholangiocarcinoma ◽  
Curative Intent ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background: Both the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for perihilar cholangiocarcinoma (pCCA) had the same definition for T2a and T2b. But the value of this classification as prognostic factor remains unclear. Methods: 178 patients with stage T2a or T2b who underwent curative intent resection for pCCA between Jan 2010 and Dec 2018 were enrolled. Relationships between survival and clinicopathological factors including patient demographics and tumor characteristics were evaluated using univariate and multivariate Cox regression analysis. The overall survival (OS) were calculated by Kaplan-Meier method.Results: There was no significant difference in OS between T2a and T2b groups，and the median OS duration were 37 and 31 months (P=0.354). Both the 7th and 8th edition of the AJCC TNM staging demonstrated a poor prognostic predictive performance. High level of preoperative AST (≥85.0IU/L) and CA19-9 (≥1000 U/mL), vascular resection and lower pathological differentiation of the tumor were the independent predictors for poor survival after resection.Conclusion: The newly released 8th edition of AJCC staging system demonstrated a poor ability to discriminate the prognosis of patients with stage T2a and T2b pCCA after resection.

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