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Comparison Of The Tnm9th And 8th Editions For Localized And Locally Advanced Anal Squamous Cell Carcinoma Treated Nonsurgically And Proposal Of A New Stage Grouping System.

Home
Research Domains
Biomedical And Clinical Sciences
Oncology And Carcinogenesis
Predictive And Prognostic Markers
Comparison Of The Tnm9th And 8th Editions For Localized And Locally Advanced Anal Squamous Cell Carcinoma Treated Nonsurgically And Proposal Of A New Stage Grouping System.

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Comparison of the TNM9th and 8th editions for localized and locally advanced anal squamous cell carcinoma treated nonsurgically and proposal of a new stage grouping system.

Aihong Zheng¹, Yiwen Wang², Shuang Li^3,4

¹Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China.

Cancer Medicine

|August 19, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Keywords:

TNM anal squamous cell carcinoma comparison overall survival

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The TNM 9th edition better predicts survival for anal squamous cell carcinoma (ASCC) than the 8th edition. A revised staging system shows improved prognostic value for nonmetastatic ASCC, requiring further validation.

Area of Science:

Oncology
Cancer Staging
Epidemiology

Background:

Anal squamous cell carcinoma (ASCC) staging is crucial for treatment and prognosis.
Current staging systems, like the TNM 8th and 9th editions, guide clinical decisions.
Evaluating and refining these systems is essential for improving patient outcomes.

Purpose of the Study:

To compare the survival discrimination of the TNM 9th and 8th editions for ASCC treated nonsurgically.
To propose a revised, simpler staging system for ASCC using SEER database data.
To assess the prognostic performance of existing and novel staging systems.

Main Methods:

Analysis of overall survival (OS) as the primary endpoint in 5384 ASCC patients from the SEER database.
Kaplan-Meier method, log-rank tests, correlation, and variable importance analysis (VIA) for survival comparisons.

Multivariate analysis, nomogram, calibration curves, C-index, and decision curve analysis (DCA) to evaluate staging system performance.

Main Results:

The TNM 9th edition demonstrated superior OS discrimination compared to the TNM 8th edition.
T and N stages were significant OS predictors, with T stage showing greater importance.
The TNM 9th edition exhibited ambiguity in Stage III subgroups; a new staging system showed slightly better prognostic value.

Conclusions:

The TNM 9th edition offers improved survival discrimination for ASCC over the TNM 8th edition.
A newly developed staging system shows promising prognostic accuracy for nonmetastatic ASCC.
Further validation of the proposed staging system is recommended for clinical application.