scholarly journals Analysis of Prognostic Factors from 9387 Merkel Cell Carcinoma Cases Forms the Basis for the New 8th Edition AJCC Staging System

2016 ◽  
Vol 23 (11) ◽  
pp. 3564-3571 ◽  
Author(s):  
Kelly L. Harms ◽  
Mark A. Healy ◽  
Paul Nghiem ◽  
Arthur J. Sober ◽  
Timothy M. Johnson ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Staging System ◽  
Merkel Cell ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Merkel Cell Carcinoma of the Skin

2000 ◽  
Vol 4 (4) ◽  
pp. 186-195 ◽  
Author(s):  
Patricia TH Tai ◽  
Edward Yu ◽  
Jon Tonita ◽  
James Gilchrist
Keyword(s):  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Primary Tumour ◽  
Staging System ◽  
Disease Status ◽  
Cancer Center ◽  
Merkel Cell ◽  
Distant Disease ◽  
Primary Disease

Background: Neuroendocrine/Merkel cell carcinoma (MCC) of the skin is an uncommon tumour. Currently, there are only limited data available on the natural history, prognostic factors, and patient management of MCC. Objective: To review our experience and build the largest database from the literature. Methods: Twenty-eight cases from the London Regional Cancer Center were combined with 633 cases obtained from the literature searched in English, French, German, and Chinese for the years 1966 to 1998. The database included age, sex, initial disease status at presentation to the clinic, site of primary, any coexisting disease, any previous irradiation, sizes of primary/nodal/distant metastases, management details, and final disease status. A new modified staging system was used: stage Ia (primary disease only, size < 2 cm), stage Ib (primary disease only, size > 2 cm); stage II (regional nodal disease), and stage III (beyond regional nodes and/or distant disease). Results: Age > 65 years, male sex, size of primary > 2 cm, truncal site, nodal/distant disease at presentation, and duration of disease before presentation (< 3 months) were poor prognostic factors. Surgery was the initial treatment of choice and it significantly improved overall survival (p = .004). Conclusion: We identified poor prognostic factors that may necessitate more aggressive treatment. The suggested staging system, incorporating primary tumour size, accurately predicted outcomes.

scholarly journals A nomogram for predicting overall survival in patients with Merkel cell carcinoma: A population-based analysis

2021 ◽  
Author(s):  
Miao Wang ◽  
Ye Qiu ◽  
Fang Tang ◽  
Yi-Xin Liu ◽  
Yi Li ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Staging System ◽  
Merkel Cell ◽  
Cox Regression Analysis

Abstract Background: Merkel cell carcinoma (MCC) is a rare neuroendocrine skin cancer with increasing incidence and poor prognosis. We sought to develop and validate a nomogram to estimate overall survival (OS) of MCC patients. Methods: 1863 MCC patients between 2010-2015 from the Surveillance, Epidemiology and End Results (SEER) database were randomly divided into the training and validation cohort. Independent prognostic factors determined by Cox regression analysis in the training cohort were used to establish a nomogram. We evaluated prognostic performance using the concordance index (C-index), area under receiver operating characteristic curve (AUC) and calibration curves. Decision curve analysis (DCA), net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to compared the the nomogram’s clinical utility with that of the staging system.Results: eight independent prognostic factors were incorporated in the nomogram. The C-index of the nomogram was 0.744, which was superior to the C-index of AJCC TNM Stage (0.659). The AUC was greater than 0.75 and the calibration plots of this model exhibited good performance. Additionally, the positive NRI and IDI of nomogram versus the staging system illustrated that the nomogram had better predictive accuracy than the staging system (P<0.001) and the DCA showed great clinical usefulness of the nomogram. MCC patients were perfectly classified into three risk groups by the nomogram, showing better discrimination than the staging system.Conclusions: We developed and validated a nomogram to assist clinicians in evaluating prognosis of MCC patients.

scholarly journals 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

2018 ◽  
Vol 90 (3) ◽  
pp. 191-194 ◽  
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.

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.

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