Integrating Depth of Invasion in T Classification Improves the Prognostic Performance of the American Joint Committee on Cancer Staging System for Laryngeal Squamous Cell Carcinoma: a Retrospective Multicenter Study

Abstract Background: It has been recognized that depth of invasion (DOI) is closely associated with patient survival for all types of cancer. The purpose of this study was to determine the optimal threshold and prognostic value in laryngeal squamous carcinoma (LSCC). Most importantly, we evaluated the prognostic performance of five candidate modified T-classification models in patients with LSCC. Methods: LSCC patients from Harbin Medical University Cancer Hospital and Chinese Academy of Medical Sciences Cancer Hospital were divided into training group (n=412) and validation group (n=147). The primary outcomes were overall survival (OS) and relapse-free survival (RFS), and the effect of DOI on prognosis was analyzed using a multivariable regression model. We identified the optimal model based on its simplicity, goodness of fit and Harrell's consistency index. Further independent testing was performed on the external validation queue. The nomograms was constructed to predict an individual's OS rate at one, three, and five years.Results: In multivariate analysis, we found significant associations between DOI and OS (Depth of Medium-risk invasion HR, 2.631; P <0.001. Depth of high-risk invasion: HR, 5.287; P <0.001) and RFS(Depth of high-risk invasion: HR, 1.937; P =0.016). Model 5 outperformed the American Joint Committee on Cancer (AJCC) staging system based on a low Akaike information criterion score, improvement in the concordance index, and Kaplan-Meier curves.Conclusions: Inclusion of DOI in the current AJCC staging system can improve the differentiation of T classification in LSCC patients.

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

Journal of Clinical Oncology ◽

10.1200/jco.2003.03.052 ◽

2003 ◽

Vol 21 (17) ◽

pp. 3244-3248 ◽

Cited By ~ 94

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.

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Comparing the 7th and 8th editions of UICC/AJCC staging system for nasopharyngeal carcinoma in the IMRT era

BMC Cancer ◽

10.1186/s12885-021-08036-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tao He ◽

Ruo-Nan Yan ◽

Hua-Ying Chen ◽

Yuan-Yuan Zeng ◽

Zhong-Zheng Xiang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Staging System ◽

Free Survival ◽

Intensity Modulated ◽

7Th Edition ◽

Staging Systems ◽

N Classification ◽

Ajcc Staging System ◽

Ajcc Staging ◽

T Classification

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

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.123 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 123-123

Author(s):

Motoo Nomura ◽

Tetsuya Abe ◽

Azusa Komori ◽

Yukiya Narita ◽

Shiori Uegaki ◽

...

Keyword(s):

Regression Model ◽

Cancer Patients ◽

Squamous Cell ◽

Cell Cancer ◽

Staging System ◽

Prognostic Impact ◽

American Joint Committee ◽

Staging Systems ◽

Ajcc Staging System ◽

Ajcc Staging

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.

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Stage-Specific Outcomes of Patients With Uterine Leiomyosarcoma: A Comparison of the International Federation of Gynecology and Obstetrics and American Joint Committee on Cancer Staging Systems

Journal of Clinical Oncology ◽

10.1200/jco.2008.19.8366 ◽

2009 ◽

Vol 27 (12) ◽

pp. 2066-2072 ◽

Cited By ~ 87

Author(s):

Oliver Zivanovic ◽

Mario M. Leitao ◽

Alexia Iasonos ◽

Lindsay M. Jacks ◽

Qin Zhou ◽

...

Keyword(s):

Uterine Cancer ◽

Staging System ◽

International Federation ◽

Uterine Leiomyosarcoma ◽

Figo Staging ◽

American Joint Committee ◽

Gynecology And Obstetrics ◽

Staging Systems ◽

Ajcc Staging System ◽

Ajcc Staging

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.

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Faculty Opinions recommendation of A critical analysis of the American Joint Committee on Cancer (AJCC) staging system for differentiated thyroid carcinoma in young patients on the basis of the Surveillance, Epidemiology, and End Results (SEER) registry.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.714197871.789552862 ◽

2012 ◽

Author(s):

Gilbert Cote

Keyword(s):

Thyroid Carcinoma ◽

Critical Analysis ◽

Young Patients ◽

Staging System ◽

Differentiated Thyroid Carcinoma ◽

American Joint Committee ◽

Ajcc Staging System ◽

Ajcc Staging ◽

End Results

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A simplified T classification based on the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma

Cancer Management and Research ◽

10.2147/cmar.s185860 ◽

2019 ◽

Vol Volume 11 ◽

pp. 3163-3169

Author(s):

Xing-Xi Pan ◽

Li-Hua Tong ◽

Yong-Fa Chen ◽

Fei-Long Li ◽

Wu-Bing Tang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Staging System ◽

Ajcc Staging System ◽

Ajcc Staging ◽

T Classification ◽

8Th Edition

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

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2020-0032-ra ◽

2020 ◽

Cited By ~ 2

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.

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