The American Joint Committee on Cancer (AJCC) staging system for all cancer sites, including anal cancer, is the standard for cancer staging in the United States. The AJCC staging criteria are dynamic, and periodic updates are conducted to optimize AJCC staging definitions through a panel of experts charged with evaluating new evidence to implement changes. With greater availability of large data sets, the AJCC has since restructured and updated its processes, incorporating prospectively collected data to validate stage group revisions in the version 9 AJCC staging system, including anal cancer. Survival analysis using AJCC eighth edition staging guidelines revealed a lack of hierarchical order in which stage IIIA anal cancer was associated with a better prognosis than stage IIB disease, suggesting that, for anal cancer, tumor (T) category has a greater effect on survival than lymph node (N) category. Accordingly, version 9 stage groups have been appropriately adjusted to reflect contemporary long-term outcomes. This article highlights the changes to the now published AJCC staging system for anal cancer, which: (1) redefined stage IIB as T1–T2N1M0 disease, (2) redefined stage IIIA as T3N0–N1M0 disease, and (3) eliminated stage 0 disease from its guidelines altogether.

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用于生成第 9 版美国癌症联合委员会肛门癌分期系统的生存结果

美国癌症联合委员会 (AJCC) 针对所有癌症部位（包括肛门癌）的分期系统是美国癌症分期的标准。AJCC 分期标准是动态的，并通过负责评估新证据以实施变更的专家小组进行定期更新，以优化 AJCC 分期定义。随着大数据集的可用性不断提高，AJCC 重组并更新了其流程，纳入前瞻性收集的数据，以验证第 9 版 AJCC 分期系统中的分期组修订，包括肛门癌。使用 AJCC 第八版分期指南进行的生存分析显示，IIIA 期肛门癌与 IIB 期疾病相比，缺乏分级顺序，这表明，对于肛门癌，肿瘤 (T) 类别对生存的影响大于淋巴结（N）类别。因此，第 9 版的阶段组进行了适当调整，以反映当代的长期结果。本文重点介绍了现已发布的肛门癌 AJCC 分期系统的变化，其中：(1) 将 IIB 期重新定义为 T1–T2N1M0 疾病，(2) 将 IIIA 期重新定义为 T3N0–N1M0 疾病，以及 (3) 消除了 0 期疾病完全来自其指导方针。