AJCC 7th Edition of TNM Staging Accurately Discriminates Outcomes of Patients With Resectable Intrahepatic Cholangiocarcinoma
AJCC 7th Edition of TNM Staging Accurately Discriminates Outcomes of Patients With Resectable Intrahepatic Cholangiocarcinoma
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DOI：
10.1002/cncr.25712
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发表时间：
2011-05-15
期刊：
影响因子：
6.2
通讯作者：
Regimbeau, Jean Marc
中科院分区：
文献类型：
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作者：
Farges, Olivier;Fuks, David;Regimbeau, Jean Marc
背景技术背景：今年，第7版AJCC分期手册首次将独特的pTNM分期归因于肝内胆管癌（IHCC），旨在取代目前使用的2种西方系统，理想情况下也是2种东方系统。这一提议尚未得到验证，但在目前的研究中得到了检验。方法：在1994年至2008年期间在三级肝胆中心进行的522例IHCC根治性手术患者中，保留了肿块形成型IHCC、RO切除和准确病理结分期的患者进行评价。比较这些患者在新TNM分期（以及之前的4个TNM分期）中的分布及其精算生存率。研究结果：只有163例患者符合纳入标准，主要是因为缺乏常规淋巴结清扫术，但这一人群的患者和肿瘤特征具有代表性。这些患者在AJCC第7版分期之间均匀分布（I期，28%; II期，32%; III期，35%），而其他系统的情况并非如此。存活者平均随访34个月，AJCC第7版在预测存活率方面比其他版本更具鉴别力（I期未达到的中位数; II期为53个月，P = 0.01; III期为16个月，P = 0.05）。
BACKGROUND: This year, the 7th edition of the AJCC staging manual has for the first time attributed a unique pTNM staging to intrahepatic cholangiocarcinoma (IHCC) that is intended to replace the 2 Western and ideally also the 2 Eastern systems currently in use. This proposal, which has not yet been validated, was tested in the current study. METHODS: Among 522 patients operated on with curative intent for an IHCC between 1994 and 2008 in tertiary hepatobiliary centers, those with mass-forming-type IHCCs, an RO resection, and accurate pathological node staging were retained for evaluation. The distribution of these patients and their actuarial survival in the new TNM stages (as well as in the 4 previous ones) were compared. RESULTS: Only 163 patients fulfilled the inclusion criteria, mainly because of the lack of routine lymphadenectomy, but patients and tumors characteristics of this population were representative. These patients were evenly distributed between AJCC 7th edition stages (stage I, 28%; stage II, 32%; stage III, 35%), which was not the case for the other systems. With an average follow-up of 34 months in survivors, the AJCC 7th edition was more discriminating than the others in predicting survival (median for stage I not reached; for stage II, 53 months, P = .01; for stage III, 16 months, P