Abstract
BackgroundWhether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable. We aimed to compare the predictive capacity of the AJCC-7 for colorectal cancer with the 6th edition of the AJCC TNM staging system (AJCC-6).MethodsThe National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) dataset consisting of 158,483 records was used in this study. We evaluated the predictive capacity of the two editions of the staging system using Harrell’s C index and Bayesian Information Criterion (BIC).ResultsThere was a significant prognostic difference between patients at stage IIB and IIC (P < 0.001). Stage III patients with similar prognoses were adequately sub-grouped in the same stage according to AJCC-7. The Harrell’s C index revealed a value of 0.7692 for AJCC-7, which was significantly better than 0.7663 for AJCC-6 (P < 0.001). BIC analysis provided consistent results (P < 0.001).ConclusionsThis study demonstrates that AJCC-7 is superior to the AJCC-6 staging system in predictive capacity.
Highlights
Whether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable
Regarding stage II, we found significant differences in prognosis between patients categorized as AJCC-7 stage IIB and IIC (P < 0.001) (Figure 3)
When stratified by AJCC-6, significant differences in survival were not observed for AJCC-7 stage IIIA (P = 0.517) and IIIC (P = 0.283) patients; differences were observed for AJCC-7 stage IIIB (P < 0.001) patients (Table 2)
Summary
Whether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable. We aimed to compare the predictive capacity of the AJCC-7 for colorectal cancer with the 6th edition of the AJCC TNM staging system (AJCC-6). Accurate prognostic prediction of patients with colorectal cancer is essential for improved treatment selection. The International American Joint Committee on Cancer (AJCC) TNM staging system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer [3]. This study aimed to analyze the prognostic validity of AJCC-7 for colorectal cancer in comparison to AJCC-6; we applied the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) dataset for statistical analysis
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