Colon cancer survival rates with the new American Joint Committee on cancer sixth edition staging
Colon cancer survival rates with the new American Joint Committee on cancer sixth edition staging
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DOI：
10.1093/jnci/djh275
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发表时间：
2004-10-06
影响因子：
10.3
通讯作者：
Ko, CY
中科院分区：
文献类型：
--
作者：
O'Connell, JB;Maggard, MA;Ko, CY
背景：最近修订的美国癌症联合委员会（AJCC）第六版癌症分期系统增加了AJCC第五版系统定义的结肠癌II期和III期的分层。使用具有全国代表性的监测、流行病学和最终结果（SEER）数据，我们比较了根据两种AJCC系统定义的结肠癌分期的生存率。方法：使用SEER数据（1991年1月1日至2000年12月31日），我们确定了119363例结肠腺癌患者，并根据AJCC第五版和第六版系统定义的分期将所有患者纳入两项分析。根据SEER的“疾病范围”和“阳性[淋巴结]数目”编码方案对肿瘤进行分层。Kaplan-Meier分析用于比较总生存率和分期生存率。所有统计检验均为双侧检验。结果：总5年生存率为65.2%。根据定义的阶段与第五版系统,5年stage-specific生存阶段我93.2%,82.5%阶段II, III期为59.5%,8.1%,第四阶段。根据定义的阶段与第六版系统,5年stage-specific生存阶段我93.2%,84.7%阶段活动花絮,IIb阶段为72.2%,83.4%阶段III a,希望64.1%阶段,IIIc 44.3%阶段,第四阶段和8.1%。在第六版制度下,IIIa期结肠癌患者的5年生存率（83.4%）明显优于IIb期患者（72.2%）
Background: The recently revised American Joint Committee on Cancer (AJCC) sixth edition cancer staging system increased the stratification within colon cancer stages II and III defined by the AJCC fifth edition system. Using nationally representative Surveillance, Epidemiology, and End Results (SEER) data, we compared survival rates associated with colon cancer stages defined according to both AJCC systems. Methods: Using SEER data (from January 1, 1991, through December 31, 2000), we identified 119 363 patients with colon adenocarcinoma and included all patients in two analyses by stages defined by AJCC fifth and sixth edition systems. Tumors were stratified by SEER's "extent of disease" and "number of positive [lymph] nodes" coding schemes. Kaplan-Meier analyses were used to compare overall and stage-specific 5-year survival. All statistical tests were two-sided. Results: Overall 5-year survival was 65.2%. According to stages defined by the AJCC fifth edition system, 5-year stage-specific survivals were 93.2% for stage I, 82.5% for stage II, 59.5% for stage III, and 8.1% for stage IV. According to stages defined by the AJCC sixth edition system, 5-year stage-specific survivals were 93.2% for stage I, 84.7% for stage IIa, 72.2% for stage IIb, 83.4% for stage IIIa, 64.1 % for stage IIIb, 44.3 % for stage IIIc, and 8.1 % for stage IV. Under the sixth edition system, 5-year survival was statistically significantly better for patients with stage IIIa colon cancer (83.4%) than for patients with stage IIb disease (72.2%) (P