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. 2016 Sep 19:6:33587.
doi: 10.1038/srep33587.

Comparison of the 7(th) and proposed 8(th) editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery

Ying Jin  1   2 , Ming Chen  2   3 , Xinmin Yu  1   4
Affiliations

Comparison of the 7(th) and proposed 8(th) editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery

Ying Jin et al. Sci Rep. .

Abstract

The present study aims to compare the 7(th) and the proposed 8(th) edition of the AJCC/UICC TNM staging system for NSCLC in a cohort of patients from a single institution. A total of 408 patients with NSCLC who underwent radical surgery were analyzed retrospectively. Survivals were analyzed using the Kaplan -Meier method and were compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazard model. The Akaike information criterion (AIC) and C-index were applied to compare the two prognostic systems with different numbers of stages. The 7(th) AJCC T categories, the proposed 8(th) AJCC T categories, N categories, visceral pleural invasion, and vessel invasion were found to have statistically significant associations with disease-free survival (DFS) on univariate analysis. In the 7(th) edition staging system as well as in the proposed 8(th) edition, T categories, N categories, and pleural invasion were independent factors for DFS on multivariate analysis. The AIC value was smaller for the 8(th) edition compared to the 7(th) edition staging system. The C-index value was larger for the 8(th) edition compared to the 7(th) edition staging system. Based on the data from our single center, the proposed 8(th) AJCC T classification seems to be superior to the 7(th) AJCC T classification in terms of DFS for patients with NSCLC underwent radical surgery.

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Figures

Figure 1
Figure 1. Kaplan-Meier estimates of disease-free survival (DFS) according to the 7th edition T stage.
The 5-year DFS rates were 72%, 54%, 51%, 43% and 21% for patients with T1a (≤2 cm), T1b (>2 cm, ≤3 cm), T2a (>3 cm, ≤5 cm), T2b (>5 cm, ≤7 cm), T3 (>7 cm), respectively. P < 0.001.
Figure 2
Figure 2. Kaplan-Meier estimates of disease-free survival (DFS) according to the proposed 8th edition T stage.
The 5-year DFS rates were 100%, 68%, 54%, 52%, 49%, 43% and 21% for patients with T1a (≤1 cm), T1b (>1 cm, ≤2 cm), T1c (>2 cm, ≤3 cm), T2a (>3 cm, ≤4 cm), T2b (>4 cm, ≤5 cm), T3 (>5 cm, ≤7 cm), T4 (>7 cm), respectively. P < 0.001.
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