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Proposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinoma

2021Journal article Open access
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dc.contributor.authorZhang, XF
dc.contributor.authorXue, F
dc.contributor.authorHe, J
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, S
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, T
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, G
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorKoerkamp, B
dc.contributor.authorItaru, E
dc.contributor.authorLv, Y
dc.contributor.authorPawlik, T
dc.date.accessioned2022-03-23T15:30:40Z
dc.date.available2022-03-23T15:30:40Z
dc.date.issued2021
dc.description.abstractBackground: To improve the prognostic accuracy of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for intrahepatic cholangiocarcinoma (ICC) with establishment and validation of a modified TNM (mTNM) staging system. Methods: Data on patients who underwent curative-intent resection for ICC was collected from 15 high-volume centers worldwide (n = 643). An external validation dataset was obtained from the SEER registry (n = 797). The mTNM staging system was proposed by redefining T categories, and incorporating the recently proposed N status as N0 (no lymph node metastasis [LNM]), N1 (1-2 LNM) and N2 (≥3 LNM). Results: The 8th AJCC TNM staging system failed to stratify overall survival (OS) of stage II versus IIIA, stage IIIB versus IV, as well as overall stage III versus IV among all patients from the two databases, as well as stage I versus II, and stage III versus III among patients who had ≥6 LNs examined. There was a monotonic decrement in survival based on the proposed mTNM staging classification among patients derived from both the multi-institutional (Median OS, stage I 69.8 vs. II 37.1 vs. III 18.9 vs. IV 16.4 months, all p < 0.05), and SEER (Median OS, stage I 87.0 vs. II 29.3 vs. III 17.7 vs. IV 14.2 months, all p < 0.05) datasets, which was also verified among patients who had ≥6 lymph node harvested from both databases. Conclusion: The modified TNM staging system for ICC using the new T and N definitions provided an improved means to stratify patients relative to long-term OS versus the 8th AJCC staging.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHPB (Oxford). 2021 Sep;23(9):1456-1466.pt_PT
dc.identifier.doi10.1016/j.hpb.2021.02.009.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4016
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectBile Duct Neoplasms* / pathologypt_PT
dc.subjectBile Duct Neoplasms* / surgerypt_PT
dc.subjectBile Ducts, Intrahepatic / pathologypt_PT
dc.subjectCholangiocarcinoma* / pathologypt_PT
dc.subjectCholangiocarcinoma* / surgerypt_PT
dc.subjectHumanspt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPrognosispt_PT
dc.titleProposed Modification of the Eighth Edition of the AJCC Staging System for Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1466pt_PT
oaire.citation.startPage1456pt_PT
oaire.citation.titleHPB (Oxford)pt_PT
oaire.citation.volume23pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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