Assessment of the external validity of the AJCC 8 th staging system for small intestinal adenocarcinoma

• Verfasst von: Oweira, Hani [VerfasserIn]
• Verfasst von: Mehrabi, Arianeb [VerfasserIn]
• Verfasst von: Reißfelder, Christoph [VerfasserIn]
• Titel: Assessment of the external validity of the AJCC 8 th staging system for small intestinal adenocarcinoma
• Titelzusatz: a time to reconsider the role of tumor location?
• Verf.angabe: Hani Oweira, Omar Abdel-Rahman, Arianeb Mehrabi, Christoph Reissfelder
• Jahr: 2019
• Umfang: 8 S.
• Fussnoten: Gesehen am 18.07.2019
• Titel Quelle: Enthalten in: Journal of gastrointestinal oncology
• Ort Quelle: Hong Kong : Pioneer Bioscience Publ., 2010
• Jahr Quelle: 2019
• Band/Heft Quelle: 10(2019), 3, Seite 421-428
• ISSN Quelle: 2219-679X
• DOI: doi:10.21037/jgo.2019.01.15
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1669409716

Abstract

Background: The current study evaluates the validity and performance of the 8 th edition of the American Joint Committee on Cancer (AJCC) staging system for small intestinal adenocarcinoma patients. - Methods: Surveillance, Epidemiology and End Results (SEER) database [2004-2015] was explored and AJCC 6th, 7 th , and 8 th versions were assigned for each patient. Through Kaplan-Meier estimates, overall survival analyses were conducted. Cox regression analysis (adjusted for age, race, gender, sub-site, grade and surgical treatment) was conducted for cancer-specific survival and additionally, pairwise hazard ratio comparisons were performed. - Results: A total of 2,997 small intestinal adenocarcinoma patients were eligible and included in the analysis. Overall survival was compared according to the three AJCC staging systems. For the three versions, the P value for the trend in overall survival was significant (P th and 8 th stages were also performed, and all comparisons were significant (P vs . IIIA. C-statistic (using death from small intestinal adenocarcinoma as the dependent variable) for AJCC 6th staging system was: 0.645 [standard error (SE): 0.011; 95% CI: 0.623-0.668]; for c-statistic for AJCC 7 th staging system was 0.658 (SE: 0.011; 95% CI: 0.637-0.680); while c-statistic for AJCC 8 th staging system was 0.660 (SE: 0.011; 95% CI: 0.638-0.682). Multivariate analysis of factors affecting cancer-specific survival suggested that older age (P=0.005), higher lymph node ratio (P Conclusions: There is no evidence that AJCC 8 th system provided better prognostic characterization compared to previous AJCC staging systems for small intestinal adenocarcinoma. Subsite-specific staging paradigms should be explored in future editions of the staging system.