Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4016 |
Resumo: | 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. |
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Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic CholangiocarcinomaHCC CIRBile Duct Neoplasms* / pathologyBile Duct Neoplasms* / surgeryBile Ducts, Intrahepatic / pathologyCholangiocarcinoma* / pathologyCholangiocarcinoma* / surgeryHumansNeoplasm StagingPrognosisBackground: 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.ElsevierRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEZhang, XFXue, FHe, JAlexandrescu, SPinto Marques, HAldrighetti, LMaithel, SPulitano, CBauer, TShen, FPoultsides, GSoubrane, OMartel, GKoerkamp, BItaru, ELv, YPawlik, T2022-03-23T15:30:40Z20212021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4016engHPB (Oxford). 2021 Sep;23(9):1456-1466.10.1016/j.hpb.2021.02.009.info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:44:57ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
title |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
spellingShingle |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma Zhang, XF HCC CIR Bile Duct Neoplasms* / pathology Bile Duct Neoplasms* / surgery Bile Ducts, Intrahepatic / pathology Cholangiocarcinoma* / pathology Cholangiocarcinoma* / surgery Humans Neoplasm Staging Prognosis |
title_short |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
title_full |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
title_fullStr |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
title_full_unstemmed |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
title_sort |
Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma |
author |
Zhang, XF |
author_facet |
Zhang, XF Xue, F He, J Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, S Pulitano, C Bauer, T Shen, F Poultsides, G Soubrane, O Martel, G Koerkamp, B Itaru, E Lv, Y Pawlik, T |
author_role |
author |
author2 |
Xue, F He, J Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, S Pulitano, C Bauer, T Shen, F Poultsides, G Soubrane, O Martel, G Koerkamp, B Itaru, E Lv, Y Pawlik, T |
author2_role |
author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Zhang, XF Xue, F He, J Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, S Pulitano, C Bauer, T Shen, F Poultsides, G Soubrane, O Martel, G Koerkamp, B Itaru, E Lv, Y Pawlik, T |
dc.subject.por.fl_str_mv |
HCC CIR Bile Duct Neoplasms* / pathology Bile Duct Neoplasms* / surgery Bile Ducts, Intrahepatic / pathology Cholangiocarcinoma* / pathology Cholangiocarcinoma* / surgery Humans Neoplasm Staging Prognosis |
topic |
HCC CIR Bile Duct Neoplasms* / pathology Bile Duct Neoplasms* / surgery Bile Ducts, Intrahepatic / pathology Cholangiocarcinoma* / pathology Cholangiocarcinoma* / surgery Humans Neoplasm Staging Prognosis |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021 2021-01-01T00:00:00Z 2022-03-23T15:30:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4016 |
url |
http://hdl.handle.net/10400.17/4016 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
HPB (Oxford). 2021 Sep;23(9):1456-1466. 10.1016/j.hpb.2021.02.009. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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1777302278024200192 |