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  • Dahl, OlavHaukeland Hosp, Dept Oncol, Bergen, Norway; Univ Bergen, Med Fac, Dept Clin Sci, Bergen, Norway (author)

Evaluation of the stage classification of anal cancer by the TNM 8th version versus the TNM 7th version

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-439515
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-439515URI
  • https://doi.org/10.1080/0284186X.2020.1778180DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • Background: The UICC TNM 7th edition introduced stage groups for anal cancer which in 2019 has not yet come into general use. The new TNM 8th edition from 2016 defines 7 sub-stages. Background data for these changes are lacking. We aimed to investigate whether the new classification for anal cancer reliably predict the prognosis in the different stages.Patients and methods: The Nordic Anal Cancer Group (NOAC) conducted a large retrospective study of all anal cancers in Norway, Sweden and most of Denmark in 2000–2007. From the Nordic cohort 1151 anal cancer patients with follow-up data were classified by the TNM 4th edition which has identical T, N and M definitions as the TNM 7th edition, and therefore also can be classified by the TNM 7th stage groups. We used the Nordic cohort to translate the T, N and M stages into the TNM 8th stages and sub-stages. Overall survival for each stage was assessed.Results: Although the summary stage groups for TNM 8th edition discriminates patients with different prognosis reasonably well, the analyses of the seven sub-stages show overlapping overall survival: HR for stage IIA 1.30 (95%CI 0.80–2.12) is not significantly different from stage I (p = .30) and HR for stage IIB 2.35 (95%CI 1.40–3.95) and IIIA 2.48 (95%CI 1.43–4.31) are also similar as were HRs for stage IIIB 3.41 (95%CI 1.99–5.85) and IIIC 3.22 (95%CI 1.99–5.20). Similar overlapping was shown for local recurrence and distant spread.Conclusion: The results for the sub-stages calls for a revision of the staging system. We propose a modification of the TNM 8th edition for staging of anal cancer into four stages based on the T, N and M definitions of the TNM 8th classification.

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  • Myklebust, Mette PernilleHaukeland Hosp, Dept Oncol, Bergen, Norway (author)
  • Dale, Jon EspenHaukeland Hosp, Dept Oncol, Bergen, Norway (author)
  • Leon, OtiliaSkåne Univ Hosp, Dept Oncol, Lund, Sweden (author)
  • Serup-Hansen, EvaUniv Copenhagen, Herlev Hosp, Dept Oncol, Copenhagen, Denmark (author)
  • Jakobsen, AndersUniv Southern Denmark, Vejle Hosp, Dept Oncol, Vejle, Denmark (author)
  • Pfeiffer, PerUniv Southern Denmark, Odense Univ Hosp, Inst Clin Res, Dept Oncol, Odense C, Denmark (author)
  • Løes, Inger MarieHaukeland Hosp, Dept Oncol, Bergen, Norway (author)
  • Pfeffer, FrankHaukeland Hosp, Dept Gastroenterol Surg, Bergen, Norway; Univ Bergen, Dept Clin Med, Bergen, Norway (author)
  • Garm Spindler, Karen-LiseAarhus Univ Hosp, Dept Expt Clin Oncol, Aarhus, Denmark; Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark (author)
  • Grønlie Guren, MarianneOslo Univ Hosp, Dept Oncol, Oslo, Norway; Oslo Univ Hosp, KG Jebsen Colorectal Canc Res Ctr, Oslo, Norway (author)
  • Glimelius, BengtUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)bengglim (author)
  • Johnsson, AndersSkåne Univ Hosp, Dept Oncol, Lund, Sweden (author)
  • Haukeland Hosp, Dept Oncol, Bergen, Norway; Univ Bergen, Med Fac, Dept Clin Sci, Bergen, NorwayHaukeland Hosp, Dept Oncol, Bergen, Norway (creator_code:org_t)

Related titles

  • In:Acta Oncologica59:9, s. 1016-10230284-186X1651-226X

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