ArticleAnnals of surgical oncology2022
Nationwide Validation of the 8th American Joint Committee on Cancer TNM Staging System and Five Proposed Modifications for Resected Pancreatic Cancer.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers.
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16 citing papers in PubMed.
- UBA6 serves as a prognostic biomarker and promotes tumor progression in pancreatic ductal adenocarcinoma.Translational cancer research · 2026Article
- Lymph node involvement influences prognosis in resectable non-metastatic solid pseudopapillary tumors of the pancreas: a SEER-based population study.Updates in surgery · 2026Article
- A single-center external validation and refinement of the 9th TNM staging system for thymic epithelial tumors: a scheme enhancing prognostic stratification.Frontiers in oncology · 2026Article
- Bioelectrical impedance analysis-derived skeletal muscle mass index versus computed tomography for the detection of muscle mass reduction in patients with gastrointestinal cancer: a cross-sectional study.Frontiers in oncology · 2026Article
- End-to-end prognostication in pancreatic cancer by multimodal deep learning: a retrospective, multicenter study.European radiology · 2025Article
- Migrasome-related LncRNA features predict immune microenvironment and prognosis in pancreatic cancer.Scientific reports · 2025Article
- Evaluation of AJCC Nodal Staging for Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Ductal Adenocarcinoma.Annals of surgical oncology · 2024Article
- Construction of a combined prognostic model for pancreatic ductal adenocarcinoma based on deep learning and digital pathology images.BMC gastroenterology · 2024Article
- Distinct clinical outcomes and biological features of specific KRAS mutants in human pancreatic cancer.Cancer cell · 2024Article
- Article
- Prognostic Value of Myosteatosis and Creatinine-to-Cystatin C Ratio in Patients with Pancreatic Cancer Who Underwent Radical Surgery.Annals of surgical oncology · 2024Article
- Pancreaticoduodenectomy with Para-aortic Lymph Node Dissection for Periampullary Cancer.Indian journal of surgical oncology · 2024Article
- Biological risk based on preoperative serum CA19-9 and histological grade predicts prognosis and improves accuracy of classification in patients with pancreatic ductal adenocarcinoma.Cancer reports (Hoboken, N.J.) · 2023Article
- A new staging system for postoperative prognostication in pancreatic ductal adenocarcinoma.iScience · 2023Article
- Presence of tumor deposits is an indicator of poor prognosis in patients with pancreatic ductal adenocarcinoma.American journal of cancer research · 2023Article
- Epigenetics in Pancreatic Ductal Adenocarcinoma: Impact on Biology and Utilization in Diagnostics and Treatment.Cancers · 2022Review
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31 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prognostic value of four proposed modifications to the 8th American Joint Committee on Cancer (AJCC) TNM staging system has yet to be evaluated. This study aimed to validate five proposed modifications.
methodsPatients who underwent pancreatic ductal adenocarcinoma resection (2014-2016), as registered in the prospective Dutch Pancreatic Cancer Audit, were included. Stratification and prognostication of TNM staging systems were assessed using Kaplan-Meier curves, Cox proportional hazard analyses, and C-indices. A new modification was composed based on overall survival (OS).
resultsOverall, 750 patients with a median OS of 18 months (interquartile range 10-32) were included. The 8th edition had an increased discriminative ability compared with the 7th edition {C-index 0.59 (95% confidence interval [CI] 0.56-0.61) vs. 0.56 (95% CI 0.54-0.58)}. Although the 8th edition showed a stepwise decrease in OS with increasing stage, no differences could be demonstrated between all substages; stage IIA vs. IB (hazard ratio [HR] 1.30, 95% CI 0.80-2.09; p = 0.29) and stage IIB vs. IIA (HR 1.17, 95% CI 0.75-1.83; p = 0.48). The four modifications showed comparable prognostic accuracy (C-index 0.59-0.60); however, OS did not differ between all modified TNM stages (ns). The new modification, migrating T3N1 patients to stage III, showed a C-index of 0.59, but did detect significant survival differences between all TNM stages (p < 0.05).
conclusionsThe 8th TNM staging system still lacks prognostic value for some categories of patients, which was not clearly improved by four previously proposed modifications. The modification suggested in this study allows for better prognostication in patients with all stages of disease.
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