Multinational validation of the <scp>American Joint Committee on Cancer</scp> 8th edition pancreatic cancer staging system in a pancreas head cancer cohort

Кwon, Wook Hyun; He, Jin; Higuchi, Ryota; Son, Donghee; Lee, Seung Yeoun; Kim, Jae Ri; Kim, Hong Beom; Kim, Sun Whe; Wolfgang, Christopher L.; Cameron, John L.; Yamamoto, Masakazu; Jang, Jin‐Young

doi:10.1002/jhbp.577

Cited by 40 publications

(32 citation statements)

References 22 publications

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“…The AJCC staging system was revised for the eighth time since its first edition in 2018. Its validity was demonstrated in several studies [5][6][7]. The AJCC staging system always considered pancreatic cancers in terms of the whole pancreas, without dividing the pancreas according to the location, since pancreatic cancers in the head/uncinate process and those in the body/tail share the same prognosis and have comparable tumor biology.…”

Section: Discussionmentioning

confidence: 99%

The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

Lee

Kwon

Kim

et al. 2020

Cancers

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Identification of prognostic factors is important to improve treatment outcomes in pancreatic cancer. This study aimed to investigate the effect of the location of pancreatic cancer on survival and to determine whether it was a significant prognostic factor. Altogether, 2483 patients diagnosed with pancreatic cancer were examined. Comparative analysis of clinicopathologic characteristics, survival analysis, and multivariate analysis were performed. Cancers of the pancreatic head or the uncinate process were present in 49.5% of patients. The head/uncinate cancers had more clinical T1/T2 tumors (59.4% vs. 35.5%, p < 0.001) and a significantly higher 5-year survival rate (8.9% vs. 7.3%, p < 0.001) than the body/tail cancers. The 5-year survival rate in patients with head/uncinate cancers was significantly lower in the resectable (p = 0.014) and the locally advanced groups (p = 0.007). In patients who underwent resection with curative intent, the 5-year survival rate was lower in the head/uncinate group (p = 0.046). The overall outcome of the head/uncinate cancers was better than the body/tail cancers, due to the high proportion of resectable cases. In patients who underwent curative resection, the head/uncinate cancers had a higher number of T1/T2 tumors, but worse outcomes. In the multivariate analysis, tumor location was not an independent prognostic factor for pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

Lee

Kwon

Kim

et al. 2020

Cancers

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“…All the patients with PHC underwent the Kausch-Whipple procedure and standard lymphadenectomy along the right side of the superior mesenteric artery, the hepatoduodenal ligament, and the celiac trunk/upper pancreatic margin. PHC was confirmed histopathologically and classified according to the criteria of World Health Organization and the American Joint Committee on Cancer (AJCC) (13,14). Patients who underwent preoperative chemoradiation were excluded since it affects the ratio of fibrosis to cancer cells (15).…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of peritumoral fibrosis after resection of pancreatic head cancer

et al. 2019

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Prognostic value of peritumoral fibrosis (PF) in pancreatic head cancer after resection was evaluated. A total of 143 pancreatic cancer patients who underwent tumor resection were enrolled. All patients underwent routine preoperative examination, including contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Patients receiving preoperative chemoradiation were excluded because it affects the proportion of fibrosis and cancer cells. Histopathological confirmation and classification of pancreatic head cancer (PHC) was made according to the standards of World Health Organization and the American Joint Committee on Cancer (AJCC). The presence of fibrosis was assessed histologically, and correlated with the clinicopathological characteristics and overall survival using univariate Kaplan-Meier analysis and a stepwise multivariable Cox regression model. Vein resection, resection margin, grading, nodal status, preoperative CA19-9 levels and PF were significantly associated with overall survival. Multivariate analysis showed that all the aforementioned were independent predictive factors of survival. In addition, the survival of patients with PF was significantly worse compared to those without (HR 1.392; P=0.027). Tumor necrosis is a valuable prognostic tool that can be included in the routine post-resection histopathological evaluation of pancreatic head cancer patients.

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“…55,56 The 8th edition of the TNM staging system in exocrine pancreas, particularly PDAC, is generally well received and considered superior to the 7th edition, with more even distribution among stages and more powerful discrimination. [57][58][59][60][61][62] Yet slightly varied opinions and some refinements have been brought up in different studies. Two studies, 60,61 one from China and one from Germany, found that the new T classification had a significant advantage over the previous edition in predicting overall survival whereas the new N classification did not, which is opposite to the results of an international multicenter cohort study 62 where the revised N stage was highly prognostic, but the revised T stage was not.…”

Section: Carcinoma Of the Exocrine Pancreasmentioning

confidence: 99%

The 8th Edition American Joint Committee on Cancer Staging for Hepato-pancreato-biliary Cancer: A Review and Update

Liao

Zhang

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Cancer staging provides critical information for patients and treating physicians to battle against cancer, predict prognosis, and guide treatment decisions. The American Joint Committee on Cancer (AJCC) staging system uses a tumor, node, metastasis (TNM) scoring algorithm and is the foremost classification system for adult cancers. This system is updated every 6 to 8 years to allow sufficient time for implementation of changes and for relevant examination and discussion of data validating those changes in staging. Objective.— To review the updates in the 8th edition American Joint Committee on Cancer staging system on hepato-pancreato-biliary cancer. Data Sources.— Literature review. Conclusions.— The 8th edition, published in 2016 and implemented on January 1, 2018, has been in use for approximately 2 years. Compared with the 7th edition, some of the changes are quite radical. This review aims to provide a summary of the changes/updates of the 8th edition with focus on hepato-pancreato-biliary cancers, and evaluate its performance through literature review.

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Multinational validation of the American Joint Committee on Cancer 8th edition pancreatic cancer staging system in a pancreas head cancer cohort

Abstract: The 8th edition provides more even distribution with more powerful discrimination compared to the 7th edition.

Cited by 40 publications

References 22 publications

The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

The Role of Location of Tumor in the Prognosis of the Pancreatic Cancer

Prognostic significance of peritumoral fibrosis after resection of pancreatic head cancer

The 8th Edition American Joint Committee on Cancer Staging for Hepato-pancreato-biliary Cancer: A Review and Update

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