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Comparative Study
. 2013 Mar 17:13:123.
doi: 10.1186/1471-2407-13-123.

Is the prediction of prognosis not improved by the seventh edition of the TNM classification for colorectal cancer? Analysis of the surveillance, epidemiology, and end results (SEER) database

Peng Gao  1 , Yong-xi Song, Zhen-ning Wang, Ying-ying Xu, Lin-lin Tong, Jing-xu Sun, Miao Yu, Hui-mian Xu
Affiliations
Comparative Study

Is the prediction of prognosis not improved by the seventh edition of the TNM classification for colorectal cancer? Analysis of the surveillance, epidemiology, and end results (SEER) database

Peng Gao et al. BMC Cancer. .

Abstract

Background: Whether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable. We aimed to compare the predictive capacity of the AJCC-7 for colorectal cancer with the 6th edition of the AJCC TNM staging system (AJCC-6).

Methods: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) dataset consisting of 158,483 records was used in this study. We evaluated the predictive capacity of the two editions of the staging system using Harrell's C index and Bayesian Information Criterion (BIC).

Results: There was a significant prognostic difference between patients at stage IIB and IIC (P < 0.001). Stage III patients with similar prognoses were adequately sub-grouped in the same stage according to AJCC-7. The Harrell's C index revealed a value of 0.7692 for AJCC-7, which was significantly better than 0.7663 for AJCC-6 (P < 0.001). BIC analysis provided consistent results (P < 0.001).

Conclusions: This study demonstrates that AJCC-7 is superior to the AJCC-6 staging system in predictive capacity.

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Figures

Figure 1
Figure 1
Diagram of the major differences between the 6th and the 7th editions of the American Joint Committee on Cancer (AJCC-6 and AJCC-7, respectively) staging system for colorectal cancer.
Figure 2
Figure 2
Survival curves of patients in two datasets. Stage-dependent survival according to allocation of the patients to (a), seventh, or (b), sixth edition of the TNM classification.
Figure 3
Figure 3
Differences in cause-specific survival between patients in stage IIB and stage IIC of the seventh edition of the TNM staging system.
Figure 4
Figure 4
Survival curves of patients in stage III. Survival curves of patients in stage IIIA (yellow lines), IIIB (green lines), IIIC (blue lines) according to (a), seventh, or (b), sixth edition of the TNM staging system.
See this image and copyright information in PMC

References

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