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Optimized modification of the eighth edition of AJCC TNM staging system for resected pancreatic ductal adenocarcinoma.

Ning PuLingdi YinJoseph R HabibShanshan GaoHaijie HuYayun ZhuYong WuJun YuWenhui Lou
Published in: Future oncology (London, England) (2019)
Aim: To reassess the prognostic performance of the American Joint Committee on Cancer (AJCC) 8th edition for pancreatic ductal adenocarcinoma (PDAC) and optimize the categorization of PDAC staging. Patients & methods: A total of 11,858 patients with resected PDAC from the Surveillance, Epidemiology and End Results database were retrospectively enrolled by sequential analyses. Results: There was no statistical significance between stage IIA and IIB tumors with hazard ratios of 2.065 and 2.184 (p = 0.620) for stages IIA and IIB, respectively. With the proposed modification, there was a significant difference between the hazard ratios of stages IIIA and IIIB which were 2.481 and 2.715, respectively (p = 0.009). The C-index of modified system was 0.609, slightly higher than AJCC 8th staging system 0.604. Conclusion: We proposed a modified eighth edition of the AJCC staging system by combining stage IIA with IIB and further subclassifying stage III patients in order to lead to better discriminative power.
Keyphrases
  • lymph node
  • end stage renal disease
  • prognostic factors
  • newly diagnosed
  • ejection fraction
  • chronic kidney disease
  • pet ct
  • public health
  • squamous cell carcinoma
  • patient reported outcomes
  • young adults