Validation of the Eighth Edition of the TNM Staging System for Lung Cancer in 2043 Surgically Treated Patients With Non-small-cell Lung Cancer
Validation of the Eighth Edition of the TNM Staging System for Lung Cancer in 2043 Surgically Treated Patients With Non-small-cell Lung Cancer
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DOI：
10.1016/j.cllc.2017.04.001
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Wang, Jun
中科院分区：
文献类型：
--
作者：
Chen, Kezhong;Chen, Haiqing;Wang, Jun
第八个肺癌TNM分期系统需要外部验证。本研究评估了2043例手术治疗的非小细胞肺癌患者的性能。该系统表现出更好的性能比第七版。目的：国际肺癌研究协会提出了一个修订的肿瘤，淋巴结，转移（TNM）分类肺癌。本研究的目的是评估第八版TNM分期系统在手术治疗的非小细胞肺癌患者中的预后价值。研究方法：收集并回顾性分析了2006年1月至2015年9月期间在我们单中心接受手术治疗的2043例连续非小细胞肺癌患者的数据。采用考克斯比例风险模型评估T和N描述符的预后意义。结果：第八版对第七版中IIA期和IIB期的总生存曲线进行了修正。在预测总生存期方面有更好的预后价值，包括趋势c2统计量的更高的对数秩检验（433.6 vs. 414.2），较小的赤池信息标准值（4759.6 vs. 4768.2），Harrell C指数较高（0.776 vs. 0.769），以及较低的综合Brier评分（0.092 vs. 0.093），观察到第八版相对于第七版。按T和N描述符分层的患者亚组的无复发生存分析显示逐步恶化。IA分期患者之间存在显著差异（IAI与IA 2; P = 0.003和IA 2与IA 3; P = 0.004）。结论：第八版肺癌TNM分期系统的预后价值上级第七版。它能够很好地预测无复发生存期。(C)2017爱思唯尔公司All rights reserved.
The eighth TNM staging system for lung cancer requires external validation. The present study evaluated its performance among 2043 surgically treated patients with nonesmall-cell lung cancer. The system demonstrated better performance than the seventh edition.Purpose: The International Association for the Study of Lung Cancer has proposed a revision of the Tumor, Node, Metastasis (TNM) classification for lung cancer. The purpose of this study is to evaluate the prognostic value of the eighth edition of the TNM staging system in surgically treated patients with nonesmall-cell lung cancer. Methods: Data from 2043 consecutive patients with nonesmall-cell lung cancer who underwent surgical treatment in our single center between January 2006 and September 2015 were collected and analyzed retrospectively. Cox proportional hazard models were used to assess the prognostic significance of the T and N descriptors. Results: The reversed overall survival curves of stage IIA and stage IIB in the seventh edition were corrected in the eighth edition. Better prognostic value in predicting overall survival, including a higher log rank test of trend c 2 statistic (433.6 vs. 414.2), a smaller Akaike Information Criterion value (4759.6 vs. 4768.2), a higher Harrell C-index (0.776 vs. 0.769), and a lower integrated Brier score (0.092 vs. 0.093), was observed for the eighth edition relative to the seventh edition. Recurrencefree survival analysis of subsets of patients stratified by T and N descriptors showed a stepwise deterioration. Significant differences were found between patients of subdivided stage IA (IAI vs. IA2; P = .003 and IA2 vs. IA3; P = .004). Conclusion: The eighth edition of the TNM staging system for lung cancer has prognostic value superior to that of the seventh edition. It was able to predict recurrence-free survival well. (C) 2017 Elsevier Inc. All rights reserved.