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Comparison of two novel staging systems with the TNM system in predicting stage III colon cancer survival
Author(s) -
Walker Richard,
Wood Trevor,
LeSouder Emily,
Cleghorn Michelle,
Maganti Manjula,
MacNeill Andrea,
Quereshy Fayez A.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25009
Subject(s) - medicine , concordance , tnm staging system , stage (stratigraphy) , colorectal cancer , lymph node , staging system , oncology , survival analysis , overall survival , cancer , paleontology , biology
Background and Objectives Adaptations of the TNM staging system that incorporate the Lymph Node Ratio (LNR) have been proposed for stage III colon cancer. This study compared the concordance of two novel staging systems and the TNM system with observed survival outcomes in stage III patients. Methods A review of patients who underwent surgery for stage III colon cancer between January 2002 and April 2015 at a tertiary care centre was performed. The Kaplan‐Meier method was used to estimate the 5‐year overall (OS) and disease free survival (DFS) rates, and the concordance probability was calculated to evaluate the discriminatory power of the staging systems. Results Two hundred and sixty‐one patients were identified. For TNM stages IIIA, IIIB, and IIIC, 5‐year OS was 83.4%, 67.6%, and 38.3%, respectively ( P < 0.001). All three staging systems were independently predictive of OS and DFS ( P < 0.001). However, the novel staging system by Sugimoto et al 18 was the most favourable prognostic tool, with a concordance of 0.646 for DFS and 0.659 for OS. Conclusions The novel staging system by Sugimoto et al 18 was superior to the TNM system. Incorporating LNR into staging models for node positive colon cancers may improve survival information available to patients and potentially aid treatment decisions.