Independent validation of the 2002 American Joint Committee on cancer primary tumor classification for renal cell carcinoma using a large, single institution cohort
Independent validation of the 2002 American Joint Committee on cancer primary tumor classification for renal cell carcinoma using a large, single institution cohort
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DOI：
10.1097/01.ju.0000158043.94525.d6
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发表时间：
2005-06-01
影响因子：
6.6
通讯作者：
Zincke, H
中科院分区：
文献类型：
--
作者：
Frank, I;Blute, ML;Zincke, H
目的：美国癌症联合委员会于2002年更新了肾细胞癌（RCC）的原发肿瘤分类。到目前为止，新的分类尚未使用独立的患者组进行验证，因此，其预测患者结局的准确性尚不清楚。在目前的研究中，我们评估了2002年的原发性肿瘤分类，并比较其预测能力与1997 classification.Materials和方法：我们研究了2,746例根治性肾切除术或保留肾单位的手术治疗单侧，散发性肾癌1970年和2000年之间。使用Kaplan-Meier方法估计癌症特异性存活。1997年和2002年分类的预测能力进行了比较，使用的一致性index.Results：有812例死亡肾癌平均3.3年后肾切除术。末次随访时仍存活的患者的中位随访时间为9年。根据2002年肿瘤分类，pT 1a、pT 1b、pT 2、pT 3a、pT 3b、pT 3c和pT 4 RCC患者的估计5年癌症特异性生存率分别为97%、87%、71%、53%、44%、37%和20%。2002年分类与肾细胞癌死亡相关性的一致性指数为0.752，而1997年分类为0.737，表明2002年版本具有更强的预测能力。我们的数据表明，2002年原发性肿瘤分类将pT 1癌症细分为pT 1a和pT 1b，根据以下指标对患者进行了良好的分层癌症特异性存活率，其预测能力上级1997分类。
Purpose: The primary tumor classification for renal cell carcinoma (RCC) was updated by the American Joint Committee on Cancer in 2002. To date the new classification has not been validated using an independent group of patients and, therefore, its accuracy for predicting patient outcome is unknown. In the current study we evaluated the 2002 primary tumor classification and compared its predictive ability with that of the 1997 classification.Materials and Methods: We studied 2,746 patients treated with radical nephrectomy or nephron sparing surgery for unilateral, sporadic RCC between 1970 and 2000. Cancer specific survival was estimated using the Kaplan-Meier method. The predictive abilities of the 1997 and 2002 classifications were compared using the concordance index.Results: There were 812 deaths from RCC a mean of 3.3 years following nephrectomy. Median followup in patients still alive at last followup was 9 years. Estimated 5-year cancer specific survival rates by the 2002 tumor classification were 97%, 87%, 71%, 53%, 44%, 37% and 20% in patients with pT1a, pT1b, pT2, pT3a, pT3b, pT3c and pT4 RCC, respectively. The concordance index for the association between the 2002 classification and death from RCC was 0.752 compared with 0.737 for the 1997 classification, indicating that the 2002 version contained more predictive ability.Conclusions: Our data suggest that the 2002 primary tumor classification with pT1 cancers subclassified into pT1a and pT1b provides excellent stratification of patients according to cancer specific survival and it has a predictive ability that is superior to that of the 1997 classification.