Open AccessAssessment of the American Joint Commission on Cancer 8th Edition Staging System for Patients with Pancreatic Neuroendocrine Tumors: A Surveillance, Epidemiology, and End Results analysis
Author(s) -
Li Xiaogang,
Gou Shanmiao,
Liu Zhiqiang,
Ye Zeng,
Wang Chunyou
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1336
Subject(s) - medicine , surveillance, epidemiology, and end results , ajcc staging system , neuroendocrine tumors , proportional hazards model , stage (stratigraphy) , hazard ratio , cancer staging , epidemiology , oncology , staging system , survival analysis , pancreatic cancer , concordance , cancer , cancer registry , confidence interval , paleontology , biology
Abstract Although several staging systems have been proposed for pancreatic neuroendocrine tumors (p NET s), the optimal staging system remains unclear. Here, we aimed to assess the application of the newly revised 8th edition American Joint Committee on Cancer ( AJCC ) staging system for exocrine pancreatic carcinoma ( EPC ) to pNET s, in comparison with that of other staging systems. We identified pNET s patients from the Surveillance, Epidemiology, and End Results ( SEER ) database (2004–2014). Overall survival was analyzed using Kaplan–Meier curves with the log‐rank test. The predictive accuracy of each staging system was assessed by the concordance index (c‐index). Cox proportional hazards regression was conducted to calculate the impact of different stages. In total, 2424 patients with pNET s, including 2350 who underwent resection, were identified using SEER data. Patients with different stages were evenly stratified based on the 8th edition AJCC staging system for EPC . Kaplan–Meier curves were well separated in all patients and patients with resection using the 8th edition AJCC staging system for EPC . Moreover, the hazard ratio increased with worsening disease stage. The c‐index of the 8th edition AJCC staging system for EPC was similar to that of the other systems. For pNET s patients, the 8th edition AJCC staging system for EPC exhibits good prognostic discrimination among different stages in both all patients and those with resection.