Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Kee, Kwong‐Ming; Wang, Jing‐Houng; Lee, Chuan–Mo; Chen, Chao‐Long; Changchien, Chi‐Sin; Hu, Tsung–Hui; Cheng, Yu‐Fan; Hsu, Hsuan-Chih; Wang, Chih-Chi; Chen, Tai-Yi; Lin, Chih‐Yun; Lu, Sheng–Nan

doi:10.1002/ijc.22616

Cited by 94 publications

(66 citation statements)

References 34 publications

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“…Our results confirmed the usefulness of AJCC/UICC pTNM division for the prediction of the survival rate and hazard ratio of HCC patients [39,40]. The influence of poorly/undifferentiated cells and involvement of many liver lobes in secondary cancer on the poorer outcome of HM patients has been previously reported [41].…”

Section: Discussionsupporting

confidence: 89%

Macrophage profile in primary versus secondary liver tumors

Avădănei

Wierzbicki

Giuşcă

et al. 2014

Folia Histochem Cytobiol.

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Abstract:Macrophages are important components of the tumor-associated infiltrate and are qualified as one of the major players of the cancer-related inflammation. It was shown that tumor cells can either stimulate or mediate apoptosis of tumor-associated macrophages (TAMs). To date, there is no general agreement regarding the influence of TAMs and their numbers on the progression of hepatocellular carcinoma (HCC) and hepatic metastases (HM). To analyze the presence of TAMs and compare their numbers in intratumoral (IT) and peritumoral (PT) areas with the clinical outcome of HCC and HM patients. Biopsies from 35 HCC and 39 HM cases were analyzed. Clinical and follow-up data was enrolled for each case; the colorectal cancer was the origin of 26 HM patients. TAMs were identified by immunohistochemistry using anti-CD68 monoclonal antibody. The quantitative assessment was performed by determining the mean number of CD68-positive cells in IT and PT areas in HCC and HM. Two threshold methods were applied: threshold 1 (T1) was calculated with the use of (-log) Cox method; threshold 2 (T2) was considered as 1/3 TAMs number of group's mean. For statistical analyses Mann-Whitney U-test, Spearman's correlation, Cox proportional hazard and Kaplan-Meier tests were applied. To date, 36.12% HCC and 27.78% HM patients were alive, median survival was 5 and 17 months for HCC and HM, respectively (P = 0.05). We found significant two-fold decrease of TAMs numbers between IT vs. PT territories in both HCC and HM. A positive correlation between numbers of PT and IT TAMs was observed in HM group (r s = 0.48, P < 0.05) but not in HCC. The number of TAMs was not associated with any studied clinical factor. Univariate Cox regression analysis showed that tumor stage £ II (P = 0.01) and increased number of PT TAMs (P = 0.06, only when T2 value was applied) were associated with favorable prognosis in HCC (HR = 2.614 and 2.457, respectively). Univariate and multivariate Cox analyses in HM revealed favorable prognosis for histological grade £ G2 and one lobe tumors (P = 0.021 and 0.045; HR = 0.395 and 0.438, respectively). Survival analysis retained the impact of increased TAMs numbers in peritumoral areas (P = 0.03), tumor stages in HCC (P = 0.007), lobes' number (P = 0.007) and histological grade (P = 0.005) on HM patients' outcome. In HCC and HM the low number of TAMs in intratumoral areas was related to the tumor cell microenvironment. The increased peritumoral TAMs number in primary liver tumors was associated with better prognosis.

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Section: Discussionsupporting

confidence: 89%

Macrophage profile in primary versus secondary liver tumors

Avădănei

Wierzbicki

Giuşcă

et al. 2014

Folia Histochem Cytobiol.

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“…A smaller AIC value indicated a better model for predicting outcome. 6,7 Hazard ratios (HR) and 95% confidence intervals (95% CI) were generated. All calculations were performed using SPSS 18.0 software, and a P value of less than 0.05 was considered significant.…”

Section: Statisticsmentioning

confidence: 99%

Comparison of the 6th and 7th editions of the UICC TNM staging system for gastric cancer: Results of a Chinese single-institution study of 1,503 patients.

Wang

2011

JCO

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Aim. To evaluate the prognostic efficacy of the 7th edition tumor-node-metastasis (TNM) classification compared with the 6th edition in gastric cancer patients. Methods. A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend v 2 , likelihood ratio v 2 statistics, and Akaike information criterion (AIC) calculations.Results. Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio v 2 scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.Conclusions. Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.Gastric cancer is the fourth most common malignant tumor in the world, with an estimated 1 million new cases every year.1 More new cases of gastric cancer are diagnosed in China each year than in any other country.

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“…Она включала ряд связанных с опухолью и функцией печени признаков (> или < 50% инвазии паренхимы, наличие асцита, уровни альбумина и билирубина) [3,4]. В рамках данной шкалы выделены 3 стадии (начальная (I), средняя (II) и запущен-ная (III)) с различным прогнозом в зависимости от чис-ла позитивных признаков (0, 1-2, 3-4 соответственно).…”

Section: обзор исторического развития шкал и классификаций при гцкunclassified

“…As distinct from the other malignant tumor of liver -cholangiocellular carcinoma, there are no universal prognostic classifications for HCC [2]. International classification TNM used for majority of solid tumors is not appropriate to be 'reference' for HCC [4]. There are several prognostic scales and classifications created recently in West and Asian countries.…”

Section: информация об авторахmentioning

confidence: 99%