Impact of Tumor Grade on Pancreatic Cancer Prognosis: Validation of a Novel TNMG Staging System
| Autor: | James S. Tomlinson, Zev A. Wainberg, O. Joe Hines, Timothy R. Donahue, Jacob S. Ankeny, Matthew M. Rochefort, William H. Isacoff, Brian E. Kadera, Howard A. Reber, Graham W. Donald |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Oncology medicine.medical_specialty Oncology and Carcinogenesis Adenocarcinoma Validation Studies as Topic Metastasis Pancreatic Cancer Rare Diseases Clinical Research Pancreatic cancer Internal medicine Surveillance Epidemiology and End Results Humans Medicine Prospective Studies Oncology & Carcinogenesis Stage (cooking) Survival rate Cancer Neoplasm Staging Aged AJCC staging system business.industry Carcinoma Hazard ratio Prognosis medicine.disease Pancreatic Neoplasms Survival Rate Pancreatic Ductal Lymphatic Metastasis Female Surgery Patient Safety Neoplasm Grading Digestive Diseases business Carcinoma Pancreatic Ductal Follow-Up Studies |
| Zdroj: | Rochefort, MM; Ankeny, JS; Kadera, BE; Donald, GW; Isacoff, W; Wainberg, ZA; et al.(2013). Impact of Tumor Grade on Pancreatic Cancer Prognosis: Validation of a Novel TNMG Staging System. ANNALS OF SURGICAL ONCOLOGY, 20(13), 4322-4329. doi: 10.1245/s10434-013-3159-3. UCLA: Retrieved from: http://www.escholarship.org/uc/item/3xw82449 Annals of surgical oncology, vol 20, iss 13 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-013-3159-3 |
| Popis: | BackgroundPancreatic ductal adenocarcinoma (PDAC) patients demonstrate highly variable survival within each stage of the American Joint Committee on Cancer (AJCC) staging system. We hypothesize that tumor grade is partly responsible for this variation. Recently our group developed a novel tumor, node, metastasis, grade (TNMG) classification system utilizing Surveillance Epidemiology and End Results (SEER) data in which the presence of high tumor grade results in advancement to the next higher AJCC stage. This study's objective was to validate this TNMG staging system utilizing single-institution data.MethodsAll patients with PDAC who underwent resection at UCLA between 1990 and 2009 were identified. Clinicopathologic data reviewed included age, sex, node status, tumor size, grade, and stage. Grade was redefined as a dichotomous variable. The impact of grade on survival was assessed by Cox regression analysis. Disease was restaged into the TNMG system and compared to the AJCC staging system.ResultsWe identified 256 patients who underwent resection for PDAC. Patients with low-grade tumors experienced a 13-month improvement in median survival compared to those with high-grade tumors. On multivariate analysis, tumor grade was the strongest predictor of survival with a hazard ratio of 2.02 (p = 0.0005). Restaging disease according to the novel TNMG staging system resulted in improved survival discrimination between stages compared to the current AJCC system.ConclusionsWe were able to demonstrate that grade is one of the strongest independent prognostic factors in PDAC. Restaging with our novel TNMG system demonstrated improved prognostication. This system offers an effective and convenient way of adding grade to the current AJCC staging system. |
| Databáze: | OpenAIRE |
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