Evidence-based gallbladder cancer staging - A changing cancer staging by analysis of data from the national cancer database
Evidence-based gallbladder cancer staging - A changing cancer staging by analysis of data from the national cancer database
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DOI：
10.1097/01.sla.0000219737.81943.4e
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发表时间：
2006-06-01
影响因子：
9
通讯作者：
Choti, M
中科院分区：
文献类型：
--
作者：
Fong, YM;Wagman, L;Choti, M
背景资料：最近修订的美国癌症联合委员会（AJCC）胆囊癌分期（第6版）涉及一些重大变化。最值得注意的是，T2 N 0 M0肿瘤从II期移至IB期; T3 N1 M0疾病从III期移至IIB期; T4 NxM 0（x =任何）肿瘤从IVA期移至III期。为了确定这些变化是否有数据依据，本文收集了1989 ~ 1996年我院胆囊癌资料705例。结果：根据第6版的分期没有提供区分III期和IV期。IIA、IIB、III和IV期（第6版）的5年生存率分别为7%、9%、3%和2%。从国家癌症数据库（NCDB）的数据被用来推导出一个新的分期系统，建立在第5版，并提高了歧视的阶段组在以前的editions.Conclusions：分期系统的变化应该是合理的数据。包括NCDB在内的多中心数据库是验证循证分期系统的重要资源。
Background: A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stage IVA to stage III.Methods: In order to determine if these changes were justified by data, an analysis of the 10,705 cases of gallbladder cancer collected between 1989 and 1996 in the NCDB was performed. All patients had >5 year follow-up.Results: The staging according to the 6th Edition provided no discrimination between stage III and IV. Five-year survivals for stage IIA, IIB, III, and IV (6th Edition) were 7%, 9%, 3%, 2% respectively. The data from the National Cancer Database (NCDB) were used to derive a proposed new staging system that builds upon Edition 5 and had improved discrimination of stage groups over previous editions.Conclusions: Changes in staging systems should be justified by data. Multicenter databases, including the NCDB, represent important resources for verification of evidence-based staging systems.