Prognostic validity of the American joint committee on cancer eighth edition staging system for well-differentiated pancreatic neuroendocrine tumors
Journal
HPB : the official journal of the International Hepato Pancreato Biliary Association
Journal Volume
24
Journal Issue
5
Pages
681
Date Issued
2022
Author(s)
Wang, Hebin
Ding, Ding
Qin, Tingting
Zhang, Hang
Liu, Jun
Zhao, Junfang
Javed, Ammar
Wolfgang, Christopher
Guo, Shiwei
Chen, Qingmin
Zhao, Weihong
Shi, Wei
Zhu, Feng
Guo, Xingjun
Xu, Li
Peng, Feng
He, Ruizhi
Xu, Simiao
Jin, Jikuan
Wu, Yi
Nuer, Abula
Edil, Barish
Jin, Gang
Zheng, Lei
He, Jin
Liu, Jianhua
Liu, Yahui
Wang, Min
Qin, Renyi
Abstract
Background: The American Joint Committee on Cancer (AJCC) made improvements for staging pancreatic neuroendocrine tumors (pNETs) in its 8th Edition; however, multicenter studies were not included.
Methods: We collected multicenter datasets (n = 1,086, between 2004 and 2018) to validate the value of AJCC 8 and other coexisting staging systems through univariate and multivariate analysis for well-differentiated (G1/G2) pNETs.
Results: Compared to other coexisting staging systems, AJCC 7 only included 12 (1.1%) patients with stage III tumors. Patients with European Neuroendocrine Tumor Society (ENETS) stage IIB disease had a higher risk of death than patients with stage IIIA (hazard ratio [HR]: 4.376 vs. 4.322). For the modified ENETS staging system, patients with stage IIB disease had a higher risk of death than patients with stage III (HR: 6.078 vs. 5.341). According to AJCC 8, the proportions of patients with stage I, II, III, and IV were 25.7%, 40.3%, 23.6%, and 10.4%, respectively. As the stage advanced, the median survival time decreased (NA, 144.7, 100.8, 72.0 months, respectively), and the risk of death increased (HR: II = 3.145, III = 5.925, and IV = 8.762).
Conclusion: These findings suggest that AJCC 8 had a more reasonable proportional distribution and the risk of death was better correlated with disease stage.
SDGs
Publisher
ELSEVIER SCI LTD
Type
journal article