Validation and comparison of the 7th and 8th edition of AJCC staging systems for non-metastatic nasopharyngeal carcinoma, and proposed staging systems from Hong Kong, Guangzhou, and Guangxi
Validation and comparison of the 7th and 8th edition of AJCC staging systems for non-metastatic nasopharyngeal carcinoma, and proposed staging systems from Hong Kong, Guangzhou, and Guangxi
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第7版和第8版AJCC非转移性鼻咽癌分期系统以及香港、广州和广西提出的分期系统的验证和比较
DOI：
10.1016/j.oraloncology.2017.07.011
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发表时间：
2017-09-01
期刊：
影响因子：
4.8
通讯作者：
Xie, Fang-Yun
中科院分区：
文献类型：
--
作者：
OuYang, Pu-Yun;Xiao, Yao;Xie, Fang-Yun
目的：我们旨在验证和比较第7版和第8版非转移性鼻咽癌的AJCC分期系统，以及来自香港、广州和广西的拟议分期系统。材料和方法：我们回顾性地纳入了2002年11月5日至2010年5月27日期间治疗的899例患者。主要比较各分期系统在总生存期的分离与区分。结果：与第7次AJCC相比，第8次AJCC与所有建议的分期系统在t分类上有很好的分离。广州的t型分类判别能力最强（c指数为0.6454），其次是AJCC第8（0.6451）、AJCC第7（0.6386）、香港（0.6376）和广西（0.5889）。在n -分类方面，除广州的分期系统具有较高的潜力（P = 0.096）外，其他分期系统均未改善第7期AJCC在N2和N1分离方面的弱点。此外，广州n分类的c指数为0.6444，高于AJCC第8（0.6235）、AJCC第7（0.6179）、香港（0.6175）和广西（0.6175）。与第8期（0.6791）、第7期（0.6766）、香港期（0.6765）和广西期（0.6688）相比，广州分期系统的分期组判别性较高（c指数0.6839），但ⅰ期和ⅱ期仍不可分割（P = 0.322）。结论：第8期分期优于第7期分期。但广州提出的分级系统更有可能提高分离和识别能力。(C) 2017年作者。Elsevier Ltd.出版。
Objectives: We aimed to validate and compare the 7th and 8th edition of AJCC staging systems for non- metastatic nasopharyngeal carcinoma, and proposed staging systems from Hong Kong, Guangzhou, and Guangxi.Materials and methods: We retrospectively included 899 patients treated between November 5, 2002 and May 27, 2010. Separation and discrimination of each staging system in overall survival were primarily compared.Results: Compared with the 7th AJCC, the 8th AJCC and all proposed staging systems well separated across T-classification. T-classification from Guangzhou seemed to perform best in discrimination (C-index 0.6454), followed by the 8th AJCC (0.6451), the 7th AJCC (0.6386), Hong Kong (0.6376) and Guangxi (0.5889). For N-classification, no staging systems improved the weakness of the 7th AJCC in separating N2 and N1, except that suggestion from Guangzhou showed higher potential (P = 0.096). Besides, N-classification from Guangzhou had a C-index of 0.6444, larger than that of the 8th AJCC (0.6235), the 7th AJCC (0.6179), Hong Kong (0.6175) and Guangxi (0.6175). Accordingly, stage group of staging system from Guangzhou showed higher discrimination (C-index 0.6839), compared with the 8th AJCC (0.6791), the 7th AJCC (0.6766), Hong Kong (0.6765) and Guangxi (0.6688), despite that stage I and II remained inseparable (P = 0.322).Conclusions: The 8th AJCC staging system appeared to be better than the 7th AJCC. But the proposed staging system from Guangzhou was more likely to improve the separation and discrimination abilities. (C) 2017 The Authors. Published by Elsevier Ltd.