ArticleJournal of the National Cancer Institute2020
Melanoma Prognosis: Accuracy of the American Joint Committee on Cancer Staging Manual Eighth Edition.
Article in Journal of the National Cancer Institute, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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38 citing papers in PubMed.
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- Recurrence Patterns and Survival Outcomes in Clinical Stage IIB/IIC Melanoma: Can We Stratify Patients for Consideration of Neoadjuvant Immunotherapy?Annals of surgical oncology · 2026Article
- Bridging gaps throughout a patient's journey with melanoma: a systematic review.Melanoma management · 2025Review
- Development of Nomograms to Predict the Probability of Recurrence at Specific Sites in Patients with Cutaneous Melanoma.Cancers · 2025Article
- A novel SOX6 + melanoma cell subtype promotes early microsatellite invasion in Asian acral melanoma through fatty acid transport disorder.Journal of experimental & clinical cancer research : CR · 2025Article
- External validation of a model to predict recurrence-free and melanoma-specific survival for patients with melanoma after sentinel node biopsy.The British journal of surgery · 2025Article
- Defining high-risk patients: beyond the 8the AJCC melanoma staging system.Archives of dermatological research · 2024Article
- Patterns in progression from early-stage melanoma to late-stage melanoma: implications for survivorship follow-up.Melanoma management · 2024Article
- The Prognostic Value of the 31-Gene Expression Profile Test in Cutaneous Melanoma: A Systematic Review and Meta-Analysis.Cancers · 2024Review
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- Mitochondrial and immune response dysregulation in melanoma recurrence.Clinical and translational medicine · 2023Article
- Decoding the metastatic potential and optimal postoperative adjuvant therapy of melanoma based on metastasis score.Cell death discovery · 2023Article
- Cost-Effectiveness Analysis of Pembrolizumab as an Adjuvant Treatment of Resected Stage IIB or IIC Melanoma in the United States.Advances in therapy · 2023Article
- Pirin is a prognostic marker of human melanoma that dampens the proliferation of malignant cells by downregulating JARID1B/KDM5B expression.Scientific reports · 2023Article
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- Prediction of early-stage melanoma recurrence using clinical and histopathologic features.NPJ precision oncology · 2022Article
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Abstract
backgroundThe American Joint Committee on Cancer (AJCC) maintains that the eighth edition of its Staging Manual (AJCC8) has improved accuracy compared with the seventh (AJCC7). However, there are concerns that implementation may disrupt analysis of active clinical trials for stage III patients. We used an independent cohort of melanoma patients to test the extent to which AJCC8 has improved prognostic accuracy compared with AJCC7.
methodsWe analyzed a cohort of 1315 prospectively enrolled patients. We assessed primary tumor and nodal classification of stage I-III patients using AJCC7 and AJCC8 to assign disease stages at diagnosis. We compared recurrence-free (RFS) and overall survival (OS) using Kaplan-Meier curves and log-rank tests. We then compared concordance indices of discriminatory prognostic ability and area under the curve of 5-year survival to predict RFS and OS. All statistical tests were two-sided.
resultsStage IIC patients continued to have worse outcomes than stage IIIA patients, with a 5-year RFS of 26.5% (95% confidence interval [CI] = 12.8% to 55.1%) vs 56.0% (95% CI = 37.0% to 84.7%) by AJCC8 (P = .002). For stage I, removing mitotic index as a T classification factor decreased its prognostic value, although not statistically significantly (RFS concordance index [C-index] = 0.63, 95% CI = 0.56 to 0.69; to 0.56, 95% CI = 0.49 to 0.63, P = .07; OS C-index = 0.48, 95% CI = 0.38 to 0.58; to 0.48, 95% CI = 0.41 to 0.56, P = .90). For stage II, prognostication remained constant (RFS C-index = 0.65, 95% CI = 0.57 to 0.72; OS C-index = 0.61, 95% CI = 0.50 to 0.72), and for stage III, AJCC8 yielded statistically significantly enhanced prognostication for RFS (C-index = 0.65, 95% CI = 0.60 to 0.70; to 0.70, 95% CI = 0.66 to 0.75, P = .01).
conclusionsCompared with AJCC7, we demonstrate that AJCC8 enables more accurate prognosis for patients with stage III melanoma. Restaging a large cohort of patients can enhance the analysis of active clinical trials.
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