Evaluation of the 7(th) and 8(th) editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort.
Evaluation of the 7(th) and 8(th) editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort.
复制标题
DOI：
10.18632/oncotarget.18158
复制
发表时间：
2017-09-15
期刊：
影响因子：
--
通讯作者：
Xie Y
中科院分区：
文献类型：
--
作者：
Yang L;Wang S;Zhou Y;Lai S;Xiao G;Gazdar A;Xie Y
新的第八届美国癌症联合委员会(AJCC)/国际癌症控制联盟（UICC）肺癌分期系统是利用国际肺癌研究协会（IASLC）数据库开发和内部验证的，但需要外部验证。本研究的目的是在一个更大的、独立的非小细胞肺癌（NSCLC）队列中验证这种新的分期系统的区分能力和预后表现，该队列更侧重于北美患者。我们分析了2004 - 2013年美国国家癌症数据库（NCDB）收集的858,909例伴有一种恶性原发肿瘤的NSCLC病例。采用新的第8版AJCC/UICC肺癌分期系统的《协作分期手册》和《编码指南》的主要编码指南来定义数据库中所有患者的新的T、M和TNM分期。采用Kaplan-Meier曲线、Cox回归模型和时间相关的受试者工作特征来比较第7、修订后的第8 T、M类和总分期的区分能力和预后表现。我们证明了第8分期系统比第7分期系统提供更好的区分能力，并使用NCDB预测非小细胞肺癌患者的预后。根据临床分期和病理分期系统定义的相邻组之间存在显著的生存差异。在调整其他因素后，这些分期参数与生存率显著相关。与第7版相比，更新后的第8分期系统的T、M和总TNM分期在相邻亚组之间的区分能力有所改善，是预后的独立预测指标。
The new 8th American Joint Committee on Cancer (AJCC)/International Union for Cancer Control (UICC) lung cancer staging system was developed and internally validated using the International Association for the Study of Lung Cancer (IASLC) database, but external validation is needed. The goal of this study is to validate the discriminatory ability and prognostic performance of this new staging system in a larger, independent non-small cell lung cancer (NSCLC) cohort with greater emphasis on North American patients. A total of 858,909 NSCLC cases with one malignant primary tumor collected from 2004 to 2013 in the National Cancer Database (NCDB) were analyzed. The primary coding guidelines of the Collaborative Staging Manual and Coding Instructions for the new 8th edition AJCC/UICC lung cancer staging system was used to define the new T, M and TNM stages for all patients in the database. Kaplan-Meier curves, Cox regression models and time-dependent receiver operating characteristics were used to compare the discriminatory ability and prognostic performance of the 7th and the revised 8th T, M categories and overall stages. We demonstrated that the 8th staging system provides better discriminatory ability than the 7th staging system and predicts prognosis for NSCLC patients using the NCDB. There were significant survival differences between adjacent groups defined by both clinical staging and pathologic staging systems. These staging parameters were significantly associated with survival after adjusting for other factors. The updated T, M, and overall TNM stage of the 8th staging system show improvement compared to the 7th edition in discriminatory ability between adjacent subgroups and are independent predictors for prognosis.
登录
查看更多内容
影响因子：
20.4
作者：
Nicholson, Andrew G.;Chansky, Kari;Rami-Porta, Ramon
通讯作者：
Rami-Porta, Ramon
影响因子：
4.6
作者：
Kodama, Ken;Higashiyama, Masahiko;Kuriyama, Keiko
通讯作者：
Kuriyama, Keiko
影响因子：
2.4
作者：
Nakaya, Naoki;Goto, Koichi;Nishiwaki, Yutaka
通讯作者：
Nishiwaki, Yutaka
影响因子：
20.4
作者：
Goldstraw, Peter;Crowley, John;Sobin, Leslie
通讯作者：
Sobin, Leslie
影响因子：
20.4
作者：
Postmus, Pieter E.;Brambilla, Elisabeth;Yokomise, Hiroyasu
通讯作者：
Yokomise, Hiroyasu