Ning Pu1,2, Lingdi Yin2,3, Joseph R Habib2, Shanshan Gao2,4, Haijie Hu2,5, Yayun Zhu2,6, Yong Wu2,7, Jun Yu2, Wenhui Lou1. 1. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, PR China. 2. Department of Surgery & The Pancreatic Cancer Precision Medicine Program, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. 3. Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, & Pancreas Institute of Nanjing Medical University, Nanjing, PR China. 4. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, PR China. 5. Department of Biliary Surgery, West China Hospital of Sichuan University, Sichuan, PR China. 6. Liver Cancer Institute, Zhongshan Hospital, & Key Laboratory of Carcinogenesis & Cancer Invasion (Ministry of Education), Fudan University, Shanghai, PR China. 7. Department of General Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, PR China.
Abstract
Aim: To reassess the prognostic performance of the American Joint Committee on Cancer (AJCC) 8th edition for pancreatic ductal adenocarcinoma (PDAC) and optimize the categorization of PDAC staging. Patients & methods: A total of 11,858 patients with resected PDAC from the Surveillance, Epidemiology and End Results database were retrospectively enrolled by sequential analyses. Results: There was no statistical significance between stage IIA and IIB tumors with hazard ratios of 2.065 and 2.184 (p = 0.620) for stages IIA and IIB, respectively. With the proposed modification, there was a significant difference between the hazard ratios of stages IIIA and IIIB which were 2.481 and 2.715, respectively (p = 0.009). The C-index of modified system was 0.609, slightly higher than AJCC 8th staging system 0.604. Conclusion: We proposed a modified eighth edition of the AJCC staging system by combining stage IIA with IIB and further subclassifying stage III patients in order to lead to better discriminative power.
Aim: To reassess the prognostic performance of the American Joint Committee on Cancer (AJCC) 8th edition for pancreatic ductal adenocarcinoma (PDAC) and optimize the categorization of PDAC staging. Patients & methods: A total of 11,858 patients with resected PDAC from the Surveillance, Epidemiology and End Results database were retrospectively enrolled by sequential analyses. Results: There was no statistical significance between stage IIA and IIB tumors with hazard ratios of 2.065 and 2.184 (p = 0.620) for stages IIA and IIB, respectively. With the proposed modification, there was a significant difference between the hazard ratios of stages IIIA and IIIB which were 2.481 and 2.715, respectively (p = 0.009). The C-index of modified system was 0.609, slightly higher than AJCC 8th staging system 0.604. Conclusion: We proposed a modified eighth edition of the AJCC staging system by combining stage IIA with IIB and further subclassifying stage III patients in order to lead to better discriminative power.
Authors: Ning Pu; Joseph R Habib; Michael Bejjani; Hanlin Yin; Minako Nagai; Jianan Chen; Benedict Kinny-Köster; Qiangda Chen; Jicheng Zhang; Jun Yu; Wenchuan Wu; Wenhui Lou Journal: Ann Transl Med Date: 2021-02