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

Dahl, Olav (författare)
Haukeland Hosp, Dept Oncol, Bergen, Norway; Univ Bergen, Med Fac, Dept Clin Sci, Bergen, Norway
Myklebust, Mette Pernille (författare)
Haukeland Hosp, Dept Oncol, Bergen, Norway
Dale, Jon Espen (författare)
Haukeland Hosp, Dept Oncol, Bergen, Norway
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Leon, Otilia (författare)
Skåne Univ Hosp, Dept Oncol, Lund, Sweden
Serup-Hansen, Eva (författare)
Univ Copenhagen, Herlev Hosp, Dept Oncol, Copenhagen, Denmark
Jakobsen, Anders (författare)
Univ Southern Denmark, Vejle Hosp, Dept Oncol, Vejle, Denmark
Pfeiffer, Per (författare)
Univ Southern Denmark, Odense Univ Hosp, Inst Clin Res, Dept Oncol, Odense C, Denmark
Løes, Inger Marie (författare)
Haukeland Hosp, Dept Oncol, Bergen, Norway
Pfeffer, Frank (författare)
Haukeland Hosp, Dept Gastroenterol Surg, Bergen, Norway; Univ Bergen, Dept Clin Med, Bergen, Norway
Garm Spindler, Karen-Lise (författare)
Aarhus Univ Hosp, Dept Expt Clin Oncol, Aarhus, Denmark; Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark
Grønlie Guren, Marianne (författare)
Oslo Univ Hosp, Dept Oncol, Oslo, Norway; Oslo Univ Hosp, KG Jebsen Colorectal Canc Res Ctr, Oslo, Norway
Glimelius, Bengt (författare)
Uppsala universitet,Experimentell och klinisk onkologi
Johnsson, Anders (författare)
Skåne Univ Hosp, Dept Oncol, Lund, Sweden
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 (creator_code:org_t)
2020
2020
Engelska.
Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 59:9, s. 1016-1023
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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