Hani Oweira1,2, Arianeb Mehrabi2, Anwar Giryes1, Aysun Tekbas3, Omar Abdel-Rahman4,5. 1. Oncology Department, Swiss Cancer Institute, Cham, Switzerland. 2. Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. 3. Surgery Department, University of Jena, Jena, Germany. 4. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 5. Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Abstract
BACKGROUND: To validate the changes within the American Joint Committee on Cancer (AJCC) 8th staging system for gall bladder carcinoma compared to AJCC 7th staging system. METHODS: Surveillance, Epidemiology and End Results (SEER) database [2004-2014] was queried. Kaplan-Meier survival analyses and Log-rank testing were assessed according to both AJCC 7th and 8th staging systems. Likewise, Cox cancer-specific hazard ratio was evaluated according to both staging systems. RESULTS: Overall survival was assessed according to the two staging systems; and P values for overall trend (log/rank test) were significant (P<0.001) for both scenarios. Cox regression cancer-specific hazard adjusted for age, gender, histology, gender and surgery was evaluated according to the two staging systems. According to AJCC 7th staging system, the following pair wise hazard ratio comparisons were significant (II vs. IIIA; IIIB vs. IVA; IVA vs. IVB). According to AJCC 8th staging system, the following pair wise hazard ratio comparisons were significant (II vs. IIIA; IVA vs. IVB). C-statistic was assessed using death from gall bladder carcinoma as the dependent variable; and the findings for the two staging systems were as follows: AJCC 7th staging system: 0.684 (SE: 0.008; 95% CI: 0.667-0.701); AJCC 8th staging system: 0.682 (SE: 0.009; 95% CI: 0.665-0.698). CONCLUSIONS: There is a comparable discriminatory performance for AJCC 8th staging system compared to AJCC 7th staging system. Change form location-based to number-based N category assessment does not improve the overall prognostic performance of the staging system.
BACKGROUND: To validate the changes within the American Joint Committee on Cancer (AJCC) 8th staging system for gall bladder carcinoma compared to AJCC 7th staging system. METHODS: Surveillance, Epidemiology and End Results (SEER) database [2004-2014] was queried. Kaplan-Meier survival analyses and Log-rank testing were assessed according to both AJCC 7th and 8th staging systems. Likewise, Cox cancer-specific hazard ratio was evaluated according to both staging systems. RESULTS: Overall survival was assessed according to the two staging systems; and P values for overall trend (log/rank test) were significant (P<0.001) for both scenarios. Cox regression cancer-specific hazard adjusted for age, gender, histology, gender and surgery was evaluated according to the two staging systems. According to AJCC 7th staging system, the following pair wise hazard ratio comparisons were significant (II vs. IIIA; IIIB vs. IVA; IVA vs. IVB). According to AJCC 8th staging system, the following pair wise hazard ratio comparisons were significant (II vs. IIIA; IVA vs. IVB). C-statistic was assessed using death from gall bladder carcinoma as the dependent variable; and the findings for the two staging systems were as follows: AJCC 7th staging system: 0.684 (SE: 0.008; 95% CI: 0.667-0.701); AJCC 8th staging system: 0.682 (SE: 0.009; 95% CI: 0.665-0.698). CONCLUSIONS: There is a comparable discriminatory performance for AJCC 8th staging system compared to AJCC 7th staging system. Change form location-based to number-based N category assessment does not improve the overall prognostic performance of the staging system.
Entities:
Keywords:
Gall bladder carcinoma; Surveillance, Epidemiology and End Results (SEER); biliary tract cancer; prognosis; staging
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