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Assessment of the AJCC staging system of pheochromocytomas/paragangliomas.
Endocrine ( IF 3.7 ) Pub Date : 2021-08-27 , DOI: 10.1007/s12020-021-02854-3
Omar Abdel-Rahman 1
Affiliation  

OBJECTIVE This study aims to assess the performance of the AJCC 8th staging system for pheochromocytomas and paragangliomas (PPGLs) based on a population-based cohort. METHODS Surveillance, epidemiology, and end results (SEER)-18 registry database was reviewed, and patients with PPGLs diagnosed 2004-2015 were reviewed. AJCC stage for each patient was reconstructed from the collaborative stage dataset. Kaplan-Meier survival estimates according to the AJCC stage were reviewed, and multivariable Cox regression analysis was conducted to determine the impact of AJCC stages on overall and cancer-specific survival. RESULTS A total of 416 patients with PPGLs were eligible and were included in the current analysis. Using Kaplan-Meier survival estimates, patients with stage IV seem to have the worst overall survival (P < 0.001). When the results were stratified by the site of origin (adrenal vs. extra-adrenal), similar findings were observed in both strata (P < 0.001 in each stratum). Using multivariable Cox regression analysis for overall survival, HR for stage I vs. II was: 0.59; (95% CI: 0.27-1.27), HR for stage II vs. III: 0.82; (95% CI: 0.41-1.63), and HR for stage III vs. IV was: 0.37; (95% CI: 0.24-0.58). Likewise, for cancer-specific survival, HR for stage I vs. II was: 0.72; (95% CI: 0.26-1.97), HR for stage II vs. III: 0.64; (95% CI: 0.25-1.63), and HR for stage III vs. IV was: 0.33; (95% CI: 0.19-0.56). C-statistic for AJCC 8th staging system was: 0.723 (95% CI: 0.669-0.776). CONCLUSION Further improvements within AJCC 8th edition are possible, including the inclusion of the extent of metastatic disease in the subclassification of stage IV disease, and not considering primary tumor site when assigning T stage.

中文翻译:

评估嗜铬细胞瘤/副神经节瘤的 AJCC 分期系统。

目的 本研究旨在基于基于人群的队列评估 AJCC 第 8 期嗜铬细胞瘤和副神经节瘤 (PPGL) 分期系统的性能。方法 审查监测、流行病学和最终结果 (SEER)-18 注册数据库,并审查 2004-2015 年诊断为 PPGL 的患者。每个患者的 AJCC 阶段是从协作阶段数据集中重建的。审查了根据 AJCC 分期的 Kaplan-Meier 生存估计,并进行了多变量 Cox 回归分析以确定 AJCC 分期对总体和癌症特异性生存的影响。结果 共有 416 名 PPGL 患者符合条件,并被纳入当前分析。使用 Kaplan-Meier 生存估计,IV 期患者的总生存期似乎最差(P < 0.001)。当结果按起源部位(肾上腺与肾上腺外)分层时,在两个层中都观察到了相似的结果(每个层 P < 0.001)。对总生存期使用多变量 Cox 回归分析,I 期与 II 期的 HR 为:0.59;(95% CI:0.27-1.27),II 期与 III 期的 HR:0.82;(95% CI:0.41-1.63),III 期与 IV 期的 HR 为:0.37;(95% CI: 0.24-0.58)。同样,对于癌症特异性生存,I 期与 II 期的 HR 为:0.72;(95% CI:0.26-1.97),II 期与 III 期的 HR:0.64;(95% CI:0.25-1.63),III 期与 IV 期的 HR 为:0.33;(95% CI: 0.19-0.56)。AJCC 第 8 分期系统的 C 统计量为:0.723(95% CI:0.669-0.776)。结论 AJCC 第 8 版中的进一步改进是可能的,包括将转移性疾病的程度纳入 IV 期疾病的子分类中,
更新日期:2021-08-27
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