The Will Rogers phenomenon in the staging of breast cancer – Does it matter?

Gh, Tan; Bhoo‐Pathy, Nirmala; Taib, Nur Aishah Mohd; See, Mee-Hoong; Jamaris, Suniza; Yip, Cheng‐Har

doi:10.1016/j.canep.2014.11.005

Cited by 16 publications

(23 citation statements)

References 10 publications

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“…The results showed that although overall cancer‐specific survival had not changed, apparent improvements in cancer‐specific survival, as a consequence of altered perception of Gleason score, had occurred in all Gleason categories. The phenomenon is not restricted to prostate cancer or histological grading systems, but has been reported in cervical carcinoma after the introduction of chemo‐radiation and breast cancer after improved staging procedures .…”

Section: Discussionmentioning

confidence: 97%

The impact of the 2005 International Society of Urological Pathology consensus guidelines on Gleason grading – a matched‐pair analysis

et al. 2016

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Objectives To investigate whether the International Society of Urological Pathology (ISUP) 2005 revision of the Gleason grading system has influenced the risk of biochemical recurrence (BCR) after radical prostatectomy (RP), as the new guideline implies that some prostate cancers previously graded as Gleason score 6 (3 + 3) are now considered as 7 (3 + 4). Patients and methods A matched‐pair analysis was conducted. In all, 215 patients with Gleason score 6 or 7 (3 + 4) prostate cancer on biopsy who underwent RP before 31 December 2005 (pre‐ISUP group), were matched 1:1 by biopsy Gleason score, clinical tumour category, PSA level, and margin status to patients undergoing RP between 1 January 2008 and 31 December 2011 (post‐ISUP group). Patients were followed until BCR defined as a PSA level of ≥0.2 ng/mL. Risk of BCR was analysed in a competing‐risk model. Results The median follow‐up was 9.5 years in the pre‐ISUP group and 4.8 years in the post‐ISUP group. The 5‐year cumulative incidences of BCR were 34.0% and 13.9% in the pre‐ISUP and post‐ISUP groups, respectively (P < 0.001). The difference in cumulative incidence applied to both patients with Gleason score 6 (P < 0.001) and 7 (3 + 4) (P = 0.004). There was no difference in the 5‐year cumulative incidence of BCR between patients with pre‐ISUP Gleason score 6 and post‐ISUP Gleason score 7 (3 + 4) (P = 0.34). In a multiple Cox‐proportional hazard regression model, ISUP 2005 grading was a strong prognostic factor for BCR within 5 years of RP (hazard ratio 0.34; 95% confidence interval 0.22–0.54; P < 0.001). Conclusion The revision of the Gleason grading system has reduced the risk of BCR after RP in patients with biopsy Gleason score 6 and 7 (3 + 4). This may have consequences when comparing outcomes across studies and historical periods and may affect future treatment recommendations.

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Section: Discussionmentioning

confidence: 97%

The impact of the 2005 International Society of Urological Pathology consensus guidelines on Gleason grading – a matched‐pair analysis

et al. 2016

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“…[20][21][22] The AJCC modified their guidelines in 2002 to include classification of micrometastatic disease in sentinel lymph nodes, and to reclassify significant lymph node involvement (e.g., $ 4 positive lymph nodes) from N 1 to N 2-3 . [20][21][22] Inflammatory breast cancer is the most lethal form of breast cancer with rapid progression of local tumor and distant metastasis. 23 The clinical tumor presentation is T 4 with pre-chemotherapy identification of metastatic lymph nodes using core needle biopsy.…”

Section: Invasive Cancermentioning

confidence: 99%

“…4,5,19 TNM staging describes the tumor size, nodal involvement, and presence or absence of metastatic disease. 20,21 The American Joint Commission on Cancer (AJCC) uses TNM data to provide stage of disease and prognostic group that guide systemic treatment decisions, although information is absent about commonly used molecular markers in the clinical setting. [20][21][22] The AJCC modified their guidelines in 2002 to include classification of micrometastatic disease in sentinel lymph nodes, and to reclassify significant lymph node involvement (e.g., $ 4 positive lymph nodes) from N 1 to N 2-3 .…”

Section: Invasive Cancermentioning

confidence: 99%

“…20,21 The American Joint Commission on Cancer (AJCC) uses TNM data to provide stage of disease and prognostic group that guide systemic treatment decisions, although information is absent about commonly used molecular markers in the clinical setting. [20][21][22] The AJCC modified their guidelines in 2002 to include classification of micrometastatic disease in sentinel lymph nodes, and to reclassify significant lymph node involvement (e.g., $ 4 positive lymph nodes) from N 1 to N 2-3 . [20][21][22] Inflammatory breast cancer is the most lethal form of breast cancer with rapid progression of local tumor and distant metastasis.…”

Section: Invasive Cancermentioning

confidence: 99%

“…4,5,[18][19][20] If so, the clinical stage of disease (before chemotherapy administration) is often considered the accurate stage as compared with a downgraded pathological outcome secondary to effective chemotherapy. 4,5,[18][19][20] The histological classification of invasive breast cancers includes infiltrating ductal (70% to 80%), invasive lobular (8% to 10%), and inflammatory (2%), indicating the anatomical source of malignant cells. 4,5,19 TNM staging describes the tumor size, nodal involvement, and presence or absence of metastatic disease.…”

Section: Invasive Cancermentioning

confidence: 99%

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