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Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Clin+Oncol 2019 ; 42 (2): 160-165 Nephropedia Template TP
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An Evaluation of the Eighth Edition of the American Joint Committee on Cancer (AJCC) Staging System for Retroperitoneal Sarcomas Using the National Cancer Data Base (NCDB): Does Size Matter? #MMPMID30394881
Am J Clin Oncol 2019[Feb]; 42 (2): 160-165 PMID30394881show ga
OBJECTIVES: Retroperitoneal sarcomas (RPS) are often large at diagnosis calling into question the seventh edition AJCC size classification of <5 cm (T1) or >/=5 cm (T2). The eighth edition expands T stage into 4 categories (T1: =5 cm, T2: 515 cm). We evaluated the prognostic ability of the eighth edition using the National Cancer Database (NCDB). METHODS: Patients with RPS treated between 1998 and 2011 were identified from the NCDB; overall survival (OS) was compared. RESULTS: Of the 6427 patients identified, 9% had tumors =5 cm (n=580), 19.4% 515 cm (n=3045). With the eighth edition, stage II patients (G2/3 =5 cm) have a similar OS to stage IIIA patients (G2/3 5 cm10 cm) show a decrease in OS. Tumor size as a continuous variable had a modest effect on survival (HR, 1.004; P=0.04). On multivariate analysis, higher T-stage was associated with decreased OS (T4 HR, 1.3; P<0.001) but high grade and incomplete resection (R2) were stronger prognostic factors. The c-index for both editions were similar (80.13 eighth vs. 80.08 seventh). CONCLUSIONS: The eighth edition AJCC staging system for retroperitoneal sarcoma incorporates larger tumor size parameters that better characterize most patients, but tumor size alone is only a modest predictor of outcome.