Validation of the 8th AJCC Cancer Staging System for Pancreas Neuroendocrine Tumors Using Korean Nationwide Surgery Database
- 주제(키워드) Validation , Neoplasm staging , Pancreatic neuroendocrine tumor
- 주제(기타) Oncology
- 설명문(일반) [You, Yunghun] Konkuk Univ, Sch Med, Dept Surg, Choongju Hosp, Chungju, South Korea; [Jang, Jin-Young; Kim, Hongbeom] Seoul Natl Univ, Dept Surg, Coll Med, Seoul, South Korea; [Kim, Sang Cheol] Ulsan Univ, Asan Med Ctr, Dept Surg, Coll Med, Seoul, South Korea; [Yoon, Yoo-Seok] Seoul Natl Univ, Dept Surg, Bundang Hosp, Seongnam, South Korea; [Park, Joon Seong] Yonsei Univ, Gangnam Severance Hosp, Dept Surg, Seoul, South Korea; [Cho, Chol Kyoon] Chonnam Natl Univ, Hwasun Hosp, Dept Surg, Hwasun, South Korea; [Park, Sang-Jae] Natl Canc Ctr, Dept Surg, Goyang, South Korea; [Park, Sang-Jae] Natl Canc Ctr, Ctr Liver Canc, Goyang, South Korea; [Do Yang, Jae] Chonbuk Natl Univ, Dept Surg, Med Sch & Hosp, Jeonju, South Korea; [Lee, Woo Jung] Yonsei Univ, Severance Hosp, Dept Surg, Coll Med, Seoul, South Korea; [Hong, Tae Ho] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Hepatobiliary & Pancreas Surg, Seoul, South Korea; [Ahn, Keun Soo] Keimyung Univ, Dept Surg, Dongsan Med Ctr, Daegu, South Korea; [Jeong, Chi-Young] Gyeongsang Natl Univ, Dept Surg, Sch Med, Jinju, South Korea; [Lee, Hyeon Kook] Ewha Womans Univ, Mokdong Hosp, Sch Med, Dept Surg, Seoul, South Korea; [Lee, Seung Eun] Chung Ang Univ, Coll Med, Chung Ang Univ Hosp, Dept Surg, Seoul, South Korea; [Roh, Young Hoon] Dong A Univ, Dept Surg, Coll Med, Busan, South Korea; [Kim, Hee Joon] Chonnam Natl Univ Hosp, Dept Surg, Gwangju, South Korea; [Kim, Hongbeom] Dongguk Univ, Coll Med, Dept Surg, Ilsan Hosp, Goyang, South Korea; [Han, In Woong] Sungkyunkwan Univ, Samsung Med Ctr, Dept Surg, Sch Med, 81 Irwon Ro, Seoul 06351, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 gold, Green Submitted, Green Published
- 발행기관 KOREAN CANCER ASSOCIATION
- 발행년도 2019
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000171943
- 본문언어 영어
- Published As https://dx.doi.org/10.4143/crt.2019.023
- PubMed https://pubmed.ncbi.nlm.nih.gov/30999719
초록/요약
Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system. Materials and Methods We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included. Results Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808,13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS. Conclusion This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.
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