Abstract
The present study aims to compare the 7th and the proposed 8th edition of the AJCC/UICC TNM staging system for NSCLC in a cohort of patients from a single institution. A total of 408 patients with NSCLC who underwent radical surgery were analyzed retrospectively. Survivals were analyzed using the Kaplan –Meier method and were compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazard model. The Akaike information criterion (AIC) and C-index were applied to compare the two prognostic systems with different numbers of stages. The 7th AJCC T categories, the proposed 8th AJCC T categories, N categories, visceral pleural invasion, and vessel invasion were found to have statistically significant associations with disease-free survival (DFS) on univariate analysis. In the 7th edition staging system as well as in the proposed 8th edition, T categories, N categories, and pleural invasion were independent factors for DFS on multivariate analysis. The AIC value was smaller for the 8th edition compared to the 7th edition staging system. The C-index value was larger for the 8th edition compared to the 7th edition staging system. Based on the data from our single center, the proposed 8th AJCC T classification seems to be superior to the 7th AJCC T classification in terms of DFS for patients with NSCLC underwent radical surgery.
Highlights
Despite screening and treatment progress, Lung cancer remains the leading cause of cancer death in the People’s Republic of China as well as worldwide
The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor, node, metastasis (TNM) staging system is the main tumor-staging system used in clinical practice and research for various solid tumors, including lung cancer
A new database of 77,156 patients is being used by the International Association for the Study of Lung Cancer (IASLC) to inform the 8th edition of the TNM classification of lung cancer due to be introduced in the near future, resulting in several changes from the 7th edition, as regards the T categories[6]
Summary
Despite screening and treatment progress, Lung cancer remains the leading cause of cancer death in the People’s Republic of China as well as worldwide. The overall 5-year relative survival rate for all lung cancer patients was less than 20%. A new database of 77,156 patients is being used by the International Association for the Study of Lung Cancer (IASLC) to inform the 8th edition of the TNM classification of lung cancer due to be introduced in the near future, resulting in several changes from the 7th edition, as regards the T categories[6]. We aimed to investigate the predictive ability of the forthcoming 8th edition of the AJCC/UICC TNM classification for disease free survival (DFS) and to compare this with the 7th edition in a cohort of patients with NSCLC who underwent radical surgery with curative intent
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