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Evaluation of the 8th Edition AJCC Staging System for the Clinical Staging of Pancreatic Cancer

 Huapyong Kang  ;  Seung-Seob Kim  ;  Min Je Sung  ;  Jung Hyun Jo  ;  Hee Seung Lee  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Seung Woo Park  ;  Si Young Song  ;  Mi-Suk Park  ;  Seungmin Bang 
 CANCERS, Vol.14(19) : 4672, 2022-09 
Journal Title
Issue Date
adenocarcinoma ; lymph node ; neoplasm staging ; pancreatic neoplasms ; prognosis
The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic cancer (PC) has been validated for pathological staging; however, its significance for clinical staging remains uncertain. We validated the prognostic performance and suitability of the current staging system for the clinical staging of PC. We identified 1043 patients from our PC registry who were staged by imaging according to the 8th edition staging system and conducted analysis, including overall survival (OS) comparison. Gradual prognostic stratification according to stage hierarchy yielded significant OS differences between stage groups, except between stage I and II (p = 0.193). A substage comparison revealed no survival differences between IB (T2N0) and IIA (T3N0), which were divided by the T3 criterion only (p = 0.278). A higher N stage had significantly shorter OS than a lower N stage (all pairwise p < 0.05). However, among the 150 patients who received upfront surgery, the pathological stage was more advanced than the clinical stage in 86 (57.3%), mostly due to a false-negative cN0 (70.9%). Our results suggest that the new definition of T3 and the number-based N criteria in the 8th edition AJCC staging system may be not adequate for clinical staging. Establishing separate criteria more suitable for clinical staging should be considered.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Huapyong(강화평) ORCID logo
Kim, Seung-seob(김승섭) ORCID logo
Park, Mi-Suk(박미숙) ORCID logo
Park, Seung Woo(박승우) ORCID logo
Park, Jeong Youp(박정엽) ORCID logo
Bang, Seungmin(방승민) ORCID logo
Song, Si Young(송시영) ORCID logo
Lee, Hee Seung(이희승) ORCID logo
Chung, Moon Jae(정문재) ORCID logo
Jo, Jung Hyun(조중현) ORCID logo
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