Validation of the 8th edition of AJCC/UICC staging system for nasopharyngeal carcinoma: Results from a non-endemic cohort with 10-year follow-up
Validation of the 8th edition of AJCC/UICC staging system for nasopharyngeal carcinoma: Results from a non-endemic cohort with 10-year follow-up
复制标题
第 8 版鼻咽癌 AJCC/UICC 分期系统的验证：来自非地方性队列 10 年随访的结果
DOI：
10.1016/j.oraloncology.2019.09.029
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发表时间：
2019-11-01
期刊：
影响因子：
4.8
通讯作者：
He, Xia
中科院分区：
文献类型：
--
作者：
Wu, Li-Rong;Zhang, Xiu-Ming;He, Xia
目的：本研究旨在验证美国癌症联合委员会/国际癌症控制联盟（AJCC/UICC）第8版鼻咽癌（NPC）TNM分期系统在非地方性地区的适用性。材料与方法：收集607例经病理证实、既往未经治疗、非转移性NPC患者，均接受调强放疗（IMRT）治疗。结果：对于T分期，第8版T1、T2、T3的局部无复发生存（LRFS）Kaplan-Meier曲线分离较好;然而，T3和T4之间的LRFS没有显著差异（P = 0.166）。此外，第7版LRFS的c指数（0.702 [95% CI，0.618-0.787] vs. 0.685 [95% CI，0.604-0.767]）和AIC（766.1 vs. 770.8）均高于第8版。关于N分类，第8版实现了较高的无远处转移生存期c指数（0.796 [95% CI，0.749-0.843] vs. 0.751 [95% CI，0.696-0.805]）和较低的AIC（1439.4 vs. 1471.9）。在总分期方面，与第7版相比，第8版的总生存期c指数（0.798 [95% CI，0.753-0.844] vs. 0.721 [95% CI，0.672-0.770]）更高，AIC（1963.9 vs. 2007.2）更低。结论：AJCC/UICC TNM分期系统第8版对N分期和总体分期的预测能力明显优于第7版，但对T分期的预测能力较差。
Objectives: This study aimed to validate the 8th edition of American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for nasopharyngeal carcinoma (NPC) in non-endemic region.Materials and methods: We recruited 607 patients with histology-proven, previously untreated, non-metastatic NPC treated by intensity-modulated radiotherapy (IMRT) at our center. Harrell's concordance index (c-index) and Akaike information criterion (AIC) were applied to compare the prognostic discrimination between the 7th and 8th edition staging system.Results: For T category, the local recurrence-free survival (LRFS) Kaplan-Meier curves of T1, T2 and T3 were well separated in the 8th edition; however, LRFS did not significantly differ between T3 and T4 (P = 0.166). Moreover, the 7th edition achieved higher c-index (0.702 [95% CI, 0.618-0.787] vs. 0.685 [95% CI, 0.604-0.767]) and lower AIC (766.1 vs. 770.8) than 8th edition for LRFS. With regard to N category, the 8th edition achieved higher c-index (0.796 [95% CI, 0.749-0.843] vs. 0.751 [95% CI, 0.696-0.805]) and lower AIC (1439.4 vs. 1471.9) for distant metastasis-free survival. In terms of overall stage, the 8th edition also had higher c-index (0.798 [95% CI, 0.753-0.844] vs. 0.721 [95% CI, 0.672-0.770]) and lower AIC (1963.9 vs. 2007.2) compared with the 7th edition for overall survival. Furthermore, interval validation by bootstrapping the sample randomly for similar to 100-1000 times also validated above findings.Conclusion: The 8th edition of AJCC/UICC TNM staging system achieved significantly better prognostic discrimination than the 7th edition with regard to N category and overall stage but not T category.