Prognostic comparison of the 7th and 8th editions of the American Joint Committee on Cancer staging system for intrahepatic cholangiocarcinoma

Kang, Sang-Hyun; Hwang, Shin; Lee, Young‐Joo; Kim, Ki‐Hun; Ahn, Chul‐Soo; Moon, Deok‐Bog; Ha, Tae‐Yong; Song, Gi‐Won; Jung, Dong‐Hwan

doi:10.1002/jhbp.543

Cited by 61 publications

(58 citation statements)

References 28 publications

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“…Ahn et al [30] retrospectively analyzed 292 R0-resected ICC patients and the univariate and multivariate survival analyses of OS showed PNI as an independent significant risk factor against long-term survival, which is consistent with our results. However, some studies revealed quite different results that did not support PNI as one [31,32]. Comparatively speaking, fewer studies report the meaning of PNI to RFS.…”

Section: Discussionmentioning

confidence: 96%

Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

Zhang

Zhou

et al. 2020

BMC Cancer

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Background: Cholangiocarcinoma (CCA) is a type of malignant tumor that arises from the epithelium of the bile ducts. CCA can invade and metastasize to other tissues in a variety of ways but distal skeletal muscle metastasis is extremely rare. Case presentation: We present a case of metastasis of the right thigh from cholangiocarcinoma. Conclusion: Perineural invasion may be a pathway of distant metastasis in CCA that has not been not widely recognized. We advocate the complete removal of tumor with dissection of the nerve plexus around major vessels.

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Section: Discussionmentioning

confidence: 96%

Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

Zhang

Zhou

et al. 2020

BMC Cancer

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“…The prognostic performance of the 8th edition was overall not markedly improved over the 7th edition based on several validation studies, and potential modifications have been proposed. [17][18][19][20] Interestingly, although one study from a Korean group concluded that the new T3 did not provide good prognostic contrast, 17 a much larger study across 14 major hepatobiliary centers worldwide found the new T3 and stage III to stratify the risk of death for ICC patients. 20 On the other hand, a Japanese group found significant overlaps between T2, T3, and T4 on 5-year disease-specific survival rate, and the authors suggested modifying the size cutoff point at 2 cm for T1 (T1, size 2 cm without other factors; T2, size .2 cm without other factors), and keeping periductal infiltrating in T4 because of its prognostic significance.…”

Section: Carcinoma Of the Intrahepatic Bile Ductmentioning

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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“…A wide variety of prognostic algorithms had been proposed for ICC patients over the years. The prognostic reliability and usability of TNM stage have been questioned (5,6), and other scoring systems were established including Liver Cancer Study Group of Japan (7), Okabayashi et al (8), and Nathan et al (9). Besides, all these staging systems were based solely on variables limited to features of the primary tumor, and there remains a poor ability to predict prognosis for post-operative recurrence ICC patients, while the post-recurrence survival (PRS) of ICC patients is highly heterogeneous, and substantially impacted by features of recurrence and treatment modalities for recurrence (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

Xing

Huang

et al. 2020

Front. Oncol.

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Background: The prognosis of patients with post-operative recurrent intrahepatic cholangiocarcinoma (ICC) is at great variance. We aimed to propose a novel efficient prognostic nomogram in facilitating the risk stratification for post-operative recurrent ICC patients.Methods: From 2000 to 2016, a total of 237 post-operative recurrent ICC patients were enrolled in this study, and randomly divided into training (n = 178) and validation cohorts (n = 59) at a ratio of 3:1. The performance of this nomogram was assessed by discrimination, calibration, and clinical usefulness, and the results were compared with four other currently used ICC staging systems.Results: On multivariate analysis of the training cohort, serum CA 19-9, albumin-bilirubin grade at recurrence, time from primary resection to recurrence, tumor number at recurrence, and treatment for recurrence were selected for the model. The concordance index (C-index) of our model was 0.791 [95% confidence interval (CI), 0.736-0.846], which was statistically higher than the values of the following systems: American Joint Committee on Cancer (AJCC) 8th edition (0.610), Liver Cancer Study Group of Japan (0.613), Nathan (0.582), and Okabayashi (0.600; P < 0.001 for all). The nomogram performed well in terms of calibration when compared with actual observation. The findings were supported by the validation cohort.Conclusions: Compared with four currently used staging systems for ICC, our nomogram showed more promising clinical utility in improving individualized predictions of survival for post-operative recurrent ICC patients.

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Prognostic comparison of the 7th and 8th editions of the American Joint Committee on Cancer staging system for intrahepatic cholangiocarcinoma

Abstract: The 8th edition of the AJCC staging system appears to provide high prognostic contrast for T stage categories, except for T3. However, overall prognostic performance of the 8th edition was not markedly improved over the 7th edition.

Cited by 61 publications

References 28 publications

Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

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

A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

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