Proposed modification of the eighth edition of the AJCC staging system for intrahepatic cholangiocarcinoma
| Autor: | Xu Feng Zhang, Timothy M. Pawlik, Guillaume Martel, Feng Xue, Sorin Alexandrescu, Bas Groot Koerkamp, Luca Aldrighetti, Shishir K. Maithel, Hugo Marques, Yi Lv, Feng Shen, Jin He, Oliver Soubrane, Carlo Pulitano, Endo Itaru, George A. Poultsides, Todd W. Bauer |
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| Přispěvatelé: | Zhang, X. -F., Xue, F., He, J., Alexandrescu, S., Marques, H. P., Aldrighetti, L., Maithel, S. K., Pulitano, C., Bauer, T. W., Shen, F., Poultsides, G. A., Soubrane, O., Martel, G., Koerkamp, B. G., Itaru, E., Lv, Y., Pawlik, T. M., Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Lymph node metastasis Stage ii TNM staging system Cholangiocarcinoma Cholangiocarcinoma* / surgery SDG 3 - Good Health and Well-being Cholangiocarcinoma* / pathology medicine Humans Stage (cooking) Bile Ducts Intrahepatic / pathology Intrahepatic Cholangiocarcinoma Intrahepatic cholangiocarcinoma AJCC staging system Neoplasm Staging Hepatology business.industry Gastroenterology External validation Cancer Bile Duct Neoplasms* / pathology medicine.disease HCC CIR Prognosis Bile Duct Neoplasms* / surgery Bile Ducts Intrahepatic Bile Duct Neoplasms Radiology business |
| Zdroj: | HPB, 23(9), 1456-1466. John Wiley & Sons Inc. |
| ISSN: | 1365-182X |
| Popis: | Background: To improve the prognostic accuracy of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for intrahepatic cholangiocarcinoma (ICC) with establishment and validation of a modified TNM (mTNM) staging system. Methods: Data on patients who underwent curative-intent resection for ICC was collected from 15 high-volume centers worldwide (n = 643). An external validation dataset was obtained from the SEER registry (n = 797). The mTNM staging system was proposed by redefining T categories, and incorporating the recently proposed N status as N0 (no lymph node metastasis [LNM]), N1 (1-2 LNM) and N2 (≥3 LNM). Results: The 8th AJCC TNM staging system failed to stratify overall survival (OS) of stage II versus IIIA, stage IIIB versus IV, as well as overall stage III versus IV among all patients from the two databases, as well as stage I versus II, and stage III versus III among patients who had ≥6 LNs examined. There was a monotonic decrement in survival based on the proposed mTNM staging classification among patients derived from both the multi-institutional (Median OS, stage I 69.8 vs. II 37.1 vs. III 18.9 vs. IV 16.4 months, all p < 0.05), and SEER (Median OS, stage I 87.0 vs. II 29.3 vs. III 17.7 vs. IV 14.2 months, all p < 0.05) datasets, which was also verified among patients who had ≥6 lymph node harvested from both databases. Conclusion: The modified TNM staging system for ICC using the new T and N definitions provided an improved means to stratify patients relative to long-term OS versus the 8th AJCC staging. info:eu-repo/semantics/publishedVersion |
| Databáze: | OpenAIRE |
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