BACKGROUND: The aim of the present study was to compare the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for pancreas head cancer and to validate the 8th edition using three multinational tertiary center data. METHODS: Data of 2,864 patients with pancreas head cancer were collected from Korea (571), Japan (824), and the USA (1,469). Survival analysis was performed to compare the 7th and 8th editions. Validation was performed by log-rank tests and test for trend repeated 1,000 times with random sets. RESULTS: In the 7th edition, 4.1%, 3.1%, 18.6%, 67.5%, 3.6%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV. In the 8th edition, 8.8%, 13.9%, 3.1%, 38.2%, 32.9%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV, respectively. The change in T category downstaged 459 patients from IIA to the new IA and IB. The new N2 category upstaged 856 patients from the former IIB to III. The 7th edition reversely stratified IA and IB. The 8th edition corrected this mis-stratification of the 7th edition, but lacked discriminatory power between IB and IIA (P = 0.271). Validation using the log-rank showed that the 8th edition provided better discrimination in 6.387 test sets among 10 tests. The test for trend validated the 8th edition to stratify stages in correct order more often (7.815/10). CONCLUSION: The 8th edition provides more even distribution with more powerful discrimination compared to the 7th edition.
BACKGROUND: The aim of the present study was to compare the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for pancreas head cancer and to validate the 8th edition using three multinational tertiary center data. METHODS: Data of 2,864 patients with pancreas head cancer were collected from Korea (571), Japan (824), and the USA (1,469). Survival analysis was performed to compare the 7th and 8th editions. Validation was performed by log-rank tests and test for trend repeated 1,000 times with random sets. RESULTS: In the 7th edition, 4.1%, 3.1%, 18.6%, 67.5%, 3.6%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV. In the 8th edition, 8.8%, 13.9%, 3.1%, 38.2%, 32.9%, and 3.1% were stage IA, IB, IIA, IIB, III, and IV, respectively. The change in T category downstaged 459 patients from IIA to the new IA and IB. The new N2 category upstaged 856 patients from the former IIB to III. The 7th edition reversely stratified IA and IB. The 8th edition corrected this mis-stratification of the 7th edition, but lacked discriminatory power between IB and IIA (P = 0.271). Validation using the log-rank showed that the 8th edition provided better discrimination in 6.387 test sets among 10 tests. The test for trend validated the 8th edition to stratify stages in correct order more often (7.815/10). CONCLUSION: The 8th edition provides more even distribution with more powerful discrimination compared to the 7th edition.
Authors: Feng Yin; Mohammed Saad; Hao Xie; Jingmei Lin; Christopher R Jackson; Bing Ren; Cynthia Lawson; Dipti M Karamchandani; Belen Quereda Bernabeu; Wei Jiang; Teena Dhir; Richard Zheng; Christopher W Schultz; Dongwei Zhang; Courtney L Thomas; Xuchen Zhang; Jinping Lai; Michael Schild; Xuefeng Zhang; Xiuli Liu Journal: World J Gastrointest Pharmacol Ther Date: 2020-06-09
Authors: Thijs J Schouten; Lois A Daamen; Galina Dorland; Stijn R van Roessel; Vincent P Groot; Marc G Besselink; Bert A Bonsing; Koop Bosscha; Lodewijk A A Brosens; Olivier R Busch; Ronald M van Dam; Arantza Fariña Sarasqueta; Sebastiaan Festen; Bas Groot Koerkamp; Erwin van der Harst; Ignace H J T de Hingh; Martijn Intven; Geert Kazemier; Vincent E de Meijer; Vincent B Nieuwenhuijs; G Mihaela Raicu; Daphne Roos; Jennifer M J Schreinemakers; Martijn W J Stommel; M F van Velthuysen; Robert C Verdonk; Joanne Verheij; Helena M Verkooijen; Hjalmar C van Santvoort; I Quintus Molenaar Journal: Ann Surg Oncol Date: 2022-04-25 Impact factor: 4.339