Validation of the 8th Edition of the American Joint Committee on Cancer Staging System for Gallbladder Cancer and Implications for the Follow-up of Patients without Node Dissection

PurposeThe 8th edition of gallbladder cancer staging in the American Joint Committee on Cancer (AJCC) staging system changed the T and N categories.Materials and MethodsIn order to validate the new staging system, a total of 348 surgically resected gallbladder cancers were grouped based on the 8th edition of the T and N categories and compared with patients’ survival.ResultsSignificant differences were noted between T1b-T2a (p=0.003) and T2b-T3 (p < 0.001) tumors, but not between Tis-T1a, T1a-T1b, and T2a-T2b tumors. However, significant survival differences were observed both by the overall and pair-wise (T1-T2, T2-T3) comparisons (all, p < 0.001) without dividing T1/T2 subcategories. When cases with ≥ 6 examined lymph nodes were evaluated, significant survival differences were observed among the entire comparison (p < 0.001) and pair-wise comparisons of N0-N1 (p=0.001) and N1-N2 (p=0.039) lesions. When cases without nodal dissection (NX) were additionally compared, significant survival differences were observed between patients with N0-NX (p=0.001) and NX-N1 (p < 0.001) lesions.ConclusionThe T category in the 8th edition of the AJCC staging system did not completely stratify the prognosis of patients with gallbladder cancer. Modification by eliminating T subcategories can better stratify the prognosis. In contrast, the N category clearly determines patients’ survival with ≥ 6 examined lymph nodes. The survival time in patients of gallbladder cancers without nodal dissection is between N0 and N1 cases. Therefore, close postoperative followed up is recommended for those patients.

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

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-05979-9 ◽

2020 ◽

Vol 277 (9) ◽

pp. 2407-2412 ◽

Cited By ~ 1

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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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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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

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2018.3.191 ◽

2018 ◽

Vol 90 (3) ◽

pp. 191-194 ◽

Cited By ~ 2

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.

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