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

Dahl, Olav ; Myklebust, Mette Pernille ; Dale, Jon Espen ; Leon, Otilia LU ; Serup-Hansen, Eva ; Jakobsen, Anders ; Pfeiffer, Per ; Løes, Inger Marie ; Pfeffer, Frank and Spindler, Karen Lise Garm , et al. (2020) In Acta Oncologica 59(9). p.1016-1023
Abstract

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... (More)

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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publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Oncologica
volume
59
issue
9
pages
1016 - 1023
publisher
Taylor & Francis
external identifiers
  • scopus:85087400568
  • pmid:32574087
ISSN
0284-186X
DOI
10.1080/0284186X.2020.1778180
language
English
LU publication?
no
id
88921383-c36f-40a3-a1a3-76e25d005349
date added to LUP
2020-07-20 12:28:28
date last changed
2024-03-05 00:06:18
@article{88921383-c36f-40a3-a1a3-76e25d005349,
  abstract     = {{<p>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.</p>}},
  author       = {{Dahl, Olav and Myklebust, Mette Pernille and Dale, Jon Espen and Leon, Otilia and Serup-Hansen, Eva and Jakobsen, Anders and Pfeiffer, Per and Løes, Inger Marie and Pfeffer, Frank and Spindler, Karen Lise Garm and Guren, Marianne Grønlie and Glimelius, Bengt and Johnsson, Anders}},
  issn         = {{0284-186X}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{9}},
  pages        = {{1016--1023}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{Evaluation of the stage classification of anal cancer by the TNM 8th version versus the TNM 7th version}},
  url          = {{http://dx.doi.org/10.1080/0284186X.2020.1778180}},
  doi          = {{10.1080/0284186X.2020.1778180}},
  volume       = {{59}},
  year         = {{2020}},
}