ArticleBMC urology2022
Modified the 8th AJCC staging system for patients with advanced prostate cancer: a study based on SEER database.
Article in BMC urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 6 citations in OpenAlex.
- Immune profiling identifies the contribution of extracellular vesicles to immune modulation and progression in prostate cancer.Scientific reports · 2025Article
- Using Machine Learning to Create Prognostic Systems for Primary Prostate Cancer.Diagnostics (Basel, Switzerland) · 2025Article
- Combination approach using neoadjuvant therapy with radical prostatectomy for improving oncological outcomes of high-risk prostate cancer: a narrative review.Translational cancer research · 2024Review
- Article
- Molecular classifications of prostate cancer: basis for individualized risk stratification and precision therapy.Annals of medicine · 2023Review
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Authors and funding
6 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe American Joint Committee on Cancer (AJCC) 8th staging system of prostate cancer may be insufficient in predicting the prognosis of some staged patients. This study aimed to modify the AJCC 8th staging system in patients with advanced prostate cancer.
methodsData of patients with advanced prostate cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016 were enrolled in this cohort study. All patients were divided into the training set and the testing set with a ratio of 6:4. Multivariate Cox survival model was utilized to obtain the nomogram score for each stage variable. The modified staging system was based on the total nomogram score. The C-index and Kaplan-Meier (K-M) curves were used to show the prognostic prediction effect of patients with different staging systems.
resultsA total of 28,006 patients were included for analysis. T stage, N stage, M stage, primary Gleason pattern score, secondary Gleason pattern score, and PSA level were included as stage variables. Patients with AJCC stage III C [hazard ratio (HR) = 4.17, 95% confidence interval (CI), 3.39-5.13] and AJCC stage IV B (HR = 3.19, 95%CI, 1.79-5.69) were associated with worse prognosis compared with those of AJCC stage III B, while no statistical significance was found in patients with stage IV A (P > 0.05). In terms of the modified staging system, patients with modified stage III C (HR = 2.06, 95%CI, 1.46-2.92), modified stage IV A (HR = 6.91, 95%CI, 4.81-9.94), and modified stage IV B (HR = 21.89, 95%CI, 14.76-32.46) were associated with a poorer prognosis compared with patients with modified stage III B. The prognostic ability (C-index) of the modified staging system (0.789; 95%CI, 0.777-0.801) was better than that of the AJCC 8th edition system (0.762; 95%CI, 0.748-0.776) (0.789 vs. 0.762, P = 0.004). The K-M curves indicated that the modified staging system may be distinguished prognostic differences in patients with different stages.
conclusionModified staging system may be better than AJCC 8th staging system for predicting prognosis in prostate cancer patients. The AJCC 8th staging system should be further optimized.
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