Implications for the American Joint Committee on Cancer staging systems on esophageal squamous cell cancer patients receiving multimodality therapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 123-123
Author(s):  
Motoo Nomura ◽  
Tetsuya Abe ◽  
Azusa Komori ◽  
Yukiya Narita ◽  
Shiori Uegaki ◽  
...  

123 Background: The 7th edition of the American Joint Committee on Cancer (AJCC) staging system is based on pathologic data from esophageal cancers treated by surgery alone. The objective of this study was to evaluate the prognostic impact of the pretreatment clinical stage (cTNM) and posttreatment pathologic stage (ypTNM) on esophageal cancer patients undergoing neoadjuvant chemotherapy followed by surgery (NAC-S). Methods: Information on 245 consecutive esophageal squamous cell carcinoma patients undergoing NAC-S was reviewed. Data collected included demographics, cTNM, ypTNM, and survival. Statistical methods included the Cox regression model, Akaike information criterion (AIC) within the Cox proportional hazard regression model, and Kaplan-Meier analyses. Results: The overall three-year survival rate was 67.6%. There were significant differences between stages II and III in cTNM and ypTNM stage, respectively (P < 0.01, respectively). There were no significant survival differences between stages I and II, between stages III and IV in each TNM stage. For all patients, cN stage (cN0 vs. cN1-3), ypT stage (ypT0-2 vs. ypT3-4), ypN stage (N0 vs. N1-3), and ypM stage were independent prognostic factors by multivariate analysis (P< 0.05). Compared with cTNM stage, ypTNM stage has a smaller AIC value, which described the optimum prognostic stratification. Conclusions: Our study indicates that the ypTNM stage of the 7th edition of AJCC staging system has better performance than the cTNM stage in patients undergoing NAC-S.

2014 ◽  
Vol 25 ◽  
pp. v63
Author(s):  
Motoo Nomura ◽  
Tetsuya Abe ◽  
Hiroya Taniguchi ◽  
Shigenori Kadowaki ◽  
Daisuke Takahari ◽  
...  

2009 ◽  
Vol 27 (12) ◽  
pp. 2066-2072 ◽  
Author(s):  
Oliver Zivanovic ◽  
Mario M. Leitao ◽  
Alexia Iasonos ◽  
Lindsay M. Jacks ◽  
Qin Zhou ◽  
...  

Purpose Uterine leiomyosarcoma (LMS) is staged by the modified International Federation of Gynecology and Obstetrics (FIGO) staging system for uterine cancer. We aimed to determine whether the American Joint Committee on Cancer (AJCC) soft tissue sarcoma (STS) staging system is more accurate in predicting progression-free survival (PFS) and overall survival (OS). Patients and Methods Patients with uterine LMS who presented at our institution from 1982 to 2005 were staged retrospectively according to a modified FIGO staging system and the AJCC STS staging system. The predictive accuracy of the two staging systems was compared using concordance estimation. Results Two hundred nineteen patients had sufficient clinical and pathologic information to be staged under both systems; 132 patients were upstaged using the AJCC staging system, whereas only four were downstaged. Stage-specific PFS and OS rates for stages I, II, and III differed substantially between the two staging systems. In both systems, there was prognostic overlap between stages II and III. Thus, despite the marked stage-specific differences in 5-year PFS and OS rates for stages I, II, and III, both systems had similar concordance indices. Conclusion Estimates of stage-specific PFS and OS for uterine LMS were altered substantially when using the AJCC versus FIGO staging system. Adjuvant treatment strategies should be tested in patients at substantial risk for disease progression and death. Neither the FIGO nor AJCC staging system is ideal for identifying such patients, suggesting a need for a uterine LMS-specific staging system to better target patients for trials of adjuvant therapies.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14506-14506 ◽  
Author(s):  
J. Y. Luh ◽  
S. J. Wang ◽  
C. D. Fuller ◽  
C. R. Thomas

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.


2003 ◽  
Vol 21 (17) ◽  
pp. 3244-3248 ◽  
Author(s):  
Wendy A. Woodward ◽  
Eric A. Strom ◽  
Susan L. Tucker ◽  
Marsha D. McNeese ◽  
George H. Perkins ◽  
...  

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.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tao He ◽  
Ruo-Nan Yan ◽  
Hua-Ying Chen ◽  
Yuan-Yuan Zeng ◽  
Zhong-Zheng Xiang ◽  
...  

Abstract Background To compare the prognostic value of 7th and 8th editions of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system for patients with nonmetastatic nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy and simultaneous integrated boost– intensity-modulated radiation therapy (SIB-IMRT). Methods Patients with NPC (n = 300) who received SIB-IMRT were included. Survival by T-classification, N-classification, and stage group of each staging system was assessed. Results For T-classification, nonsignificant difference was observed between T1 and T3 and between T2 and T3 disease (P = 0.066 and 0.106, respectively) for overall survival (OS) in the 7th staging system, whereas all these differences were significant in the 8th staging system (all P < 0.05). The survival curves for disease-free survival (DFS) and locoregional recurrence-free survival (LRRFS) in both staging systems were similar, except for the comparison of T2 and T4 disease for LRRFS (P = 0.070 for 7th edition; P = 0.011 for 8th edition). For N-classification, significant differences were observed between N2 and N3 diseases after revision (P = 0.046 and P = 0.043 for OS and DFS, respectively). For staging system, no significant difference was observed between IVA and IVB of 7th edition. Conclusion The 8th AJCC staging system appeared to have superior prognosis value in the SIB-IMRT era compared with the 7th edition.


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