Proposal for a New TNM Stage based on the 7(th) and 8(th) American Joint Committee on Cancer pTNM Staging Classification for Gastric Cancer.
Proposal for a New TNM Stage based on the 7(th) and 8(th) American Joint Committee on Cancer pTNM Staging Classification for Gastric Cancer.
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基于第七届和第八届美国癌症联合委员会胃癌 pTNM 分期分类的新 TNM 分期提案
DOI：
10.7150/jca.26351
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发表时间：
2018
影响因子：
3.9
通讯作者：
Xu RH
中科院分区：
文献类型：
--
作者：
Qiu MZ;Wang ZX;Zhou YX;Yang DJ;Wang FH;Xu RH
背景：第8版美国癌症联合委员会（AJCC）胃癌分期系统纳入了几项新变化。本研究旨在比较AJCC pTNM第7和第8分期系统对胃癌患者的预后价值，并提出一种更精确的分期方法。方法：检索SEER数据库，以确定2004年至2009年期间的GC患者。来自中山大学肿瘤防治中心（SYSUCC）的GC患者用作外部验证数据。采用Kaplan-Meier法和考克斯比例风险回归模型分析病因特异生存期（CSS）。采用一致性指数（c-index）、赤池信息标准（AIC）和似然比χ 2检验评估不同分期方案的预后性能。结果：在SEER队列中，8.74%的患者发生分期迁移。生存分析显示，T4bN0M0 + T4aN2M0治疗为IIIB期，T4bN3bM0治疗为IV期更好。在此基础上，我们建立了一个新的分期系统，表现出上级c指数（0.7501）优于第7和第8 AJCC分期系统（分别为0.7498和0.7500）。在AIC和似然比χ 2检验方面，新分期系统也优于第7和第8 AJCC分期系统。新分期系统的预测优势在SYSUCC数据库中仍然有效。结论：我们证明在第8届AJCC病理分期中的一些阶段修改是不必要的。因此，我们建立了一个新的分期系统，这是上级的第7和第8分期系统。
Background: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for gastric cancer incorporated several new changes. We aimed to assess the comparative prognostic values of the 7th and 8th AJCC pTNM staging systems in patients with gastric cancer (GC), and accordingly, to put forward a refined staging classification. Methods: The SEER database was queried to identify GC patients between 2004 and 2009. GC patients from Sun Yat-sen University Cancer Center (SYSUCC) were used as external validation data. The Kaplan-Meier method and Cox proportional hazards regression models were used to analyze cause-specific survival (CSS). The prognostic performance of different staging schemes was assessed using the concordance index (c-index), Akaike's information criterion (AIC), and likelihood ratio χ2 test. Results: In the SEER cohort, stage migration occurred in 8.74% of patients. Survival analysis showed that it was better to treat T4bN0M0 + T4aN2M0 as stage IIIB and T4bN3bM0 as stage IV. Based on this, we established a new staging system which exhibited a superior c-index (0.7501) to the 7th and 8th AJCC staging systems (0.7498 and 0.7500, respectively). The new staging system also outperformed the 7th and 8th AJCC staging systems in terms of AIC and the likelihood ratio χ2 test. The predictive superiority of the new staging system remained valid in the SYSUCC database. Conclusions: We demonstrated that some stage modifications in the 8th AJCC pathologic staging were unnecessary. Therefore we established a new staging system, which was superior to the 7th and 8th staging systems.
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影响因子：
3.7
作者：
Wang, Wei;Sun, Xiao-wei;Zhou, Zhi-wei
通讯作者：
Zhou, Zhi-wei
影响因子：
3.7
作者：
Qiu MZ;Qiu HJ;Wang ZQ;Ren C;Wang DS;Zhang DS;Luo HY;Li YH;Xu RH
通讯作者：
Xu RH
影响因子：
--
作者：
Yang L;Wang S;Zhou Y;Lai S;Xiao G;Gazdar A;Xie Y
通讯作者：
Xie Y
影响因子：
--
作者：
Cao Y;Liu H;Zhang H;Lin C;Li R;Wu S;Li H;He H;Zhang W;Xu J
通讯作者：
Xu J
影响因子：
45.3
作者：
Zivanovic, Oliver;Leitao, Mario M.;Hensley, Martee L.
通讯作者：
Hensley, Martee L.