A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer

Abstract

Background:Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual.Methods:We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses.Results:This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I–III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P = 0.001) and 5-year OS (χ2 = 5.225, P = 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P = 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P = 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant differences in either 5-year DFS (χ2 = 0.440, P = 0.507) or 5-year OS (χ2 = 1.530, P = 0.216).Conclusions:The prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

Integration of Ki-67 index into AJCC 2018 staging provides additional prognostic information in breast tumours candidate for genomic profiling

“…The results obtained confirm that integration of tumour load (size and presence of node involvement) with tumour type (grade and prognostic factors) leads to an increased number of patients classified as stage I, as previously reported. 16,17 Furthermore, in line with other studies, 18,19 we found that stage I according to PS clearly identifies a group of patients with a more favourable outcome, distinguishing them from other patients with lesions classified as stage II or III and providing more accurate prognostic information compared with AS.…”

Salivary Biomarkers for Oral Squamous Cell Carcinoma Diagnosis and Follow-Up: Current Status and Perspectives

“…The evaluation of these cancer biomarkers in liquid biopsy has the advantage of providing a real-time picture of primary and metastatic tumors at different time points, giving information about tumor and tumor burden and early evidence of drug resistance and tumor recurrence (Di Meo et al, 2017). Moreover, liquid biopsy analysis allows defining of the DNA molecular profile of cancer patients, whose inclusion in the tumor, node, and metastasis staging system may help to develop more highly personalized therapies and decrease risks of inappropriate treatments (Xu et al, 2017).…”

Validation of the Prognostic Significance of the Prognostic Stage Group According to the Eighth Edition of American Cancer Joint Committee on Cancer Staging System in Triple-Negative Breast Cancer: An Analysis From Surveillance, Epidemiology, and End Results 18 Database

“…Another study published by Wang M et al 4 found that the prognostic stage provided accurate prognostic information for locally advanced breast cancer compared with anatomic TNM stage. In China, Liu YH et al [5][6][7] published a series of articles about the prognostic value of the new staging system in luminal A, luminal B, HER2-negative, HER2-enriched breast cancer patients, demonstrating that the prognostic stages refines the anatomic stages and will lead to a more personalized guidance to the selection of therapy. More additional retrospective studies have also confirmed the improved accuracy of the new staging system and its increasing relevance under the current medical strategies.…”