Validation of the 8th AJCC Cancer Staging System for Pancreas Neuroendocrine Tumors Using Korean Nationwide Surgery Databaseopen access
- You, Yunghun; Jang, Jin-Young; Kim, Sang Cheol; Yoon, Yoo-Seok; Park, Joon Seong; Cho, Chol Kyoon; Park, Sang-Jae; Do Yang, Jae; Lee, Woo Jung; Hong, Tae Ho; Ahn, Keun Soo; Jeong, Chi-Young; Lee, Hyeon Kook; Lee, Seung Eun; Roh, Young Hoon; Kim, Hee Joon; Kim, Hongbeom; Han, In Woong
- Issue Date
- KOREAN CANCER ASSOCIATION
- Validation; Neoplasm staging; Pancreatic neuroendocrine tumor
- CANCER RESEARCH AND TREATMENT, v.51, no.4, pp.1639 - 1652
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Start Page
- End Page
- Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system. Materials and Methods We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included. Results Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808,13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS. Conclusion This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.
- Files in This Item
- There are no files associated with this item.
- Appears in
- College of Medicine > Department of Medicine > Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.