Evaluation of the stage classification of anal cancer by the TNM 8th version versus the TNM 7th version
(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.
(Less)
- author
- publishing date
- 2020-06-23
- 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}}, }