Can American Joint Committee on Cancer prognostic groups be individualized in patients undergoing surgery for Stage IV invasive upper tract Urothelial Carcinoma?

Li, Zaishang1,2,3; Li, Xueying4; Liu, Ying1,2,3; Fang, Jiequn1,2,3; Zhang, Xueqi1,2,3; Xiao, Kefeng1,2,3

2021

10.7150/jca.50417

Journal of Cancer   影响因子和分区

1837-9664

["Purpose: We explored whether the modified American Joint Committee on Cancer tumor-node-metastasis prognostic stage group IV can be individualized in a large population-based cohort of surgically treated invasive upper tract urothelial carcinoma (UTUC) patients.","Methods: Invasive UTUC patients from the Surveillance, Epidemiology and End Results database (2004-2015) were screened for inclusion. A total of 10,482 eligible cases were identified. Cancer-specific survival (CSS) after surgery was analyzed using Kaplan-Meier plots.","Results: According to the most recent pathological prognostic group classification, the 5-year mortality rates of T4NxM0 (n=493), TxN1M0 (n=597), TxN2M0 (n=424) and pTxNxM1 (n=677) patients were 41.1% (95% CI 35.2% to 47.0%), 38.6% (95% CI 33.1% to 44.1%), 40.4% (95% CI 33.0% to 47.8%) and 14.2% (95% CI 9.9% to 18.5%), respectively (T4N0M0 vs. TxNxM1, P<0.001; TxN1M0 vs. TxNxM1, P<0.001; TxN2M0 vs. TxNxM1, P<0.001). Stage IV tumors were subdivided on the basis of the mortality data (Modification 1): stage IVa tumors were considered nonmetastatic (T4NxM0, TxN1-2M0; 5-year CSS 39.9%), and stage IVb tumors were considered metastatic (pTxNxM1; 5-year CSS 14.2%). Stage IV tumors were also subdivided according to the grade classification (Modification 2): stage IVa tumors were considered low grade (T4NxM0, TxN1-2M0, TxNxM1; G1-2; n=141), and stage IVb tumors were considered metastatic (T4NxM0, TxN1-2M0, TxNxM1; G3-4; n=2050). The 5-year CSS rates for stage IVa and IVb patients were 76.3% (95% CI 68.7% to 83.9%) and 31.4% (95% CI 28.5% to 34.3%), respectively (P<0.001).","Conclusions: Stage IV patients were stratified into two prognostically different risk groups depending on metastasis or grade. The subclassification of stage IV can increase the level of prognostic detail and individualize the prediction of survival in invasive UTUC patients."]

urothelial carcinoma upper urinary tract tumor-node-metastasis mortality survival

SCI

英语

通讯

National Natural Science Foundation of China[81902610] ; Science and Technology Planning Project of Shenzhen Municipality (CN)[JCYJ20190807145409328]

Oncology

Oncology

WOS:000623069400017

IVYSPRING INT PUBL

Web of Science

1.Jinan Univ, Clin Med Coll 2, Shenzhen Peoples Hosp, Dept Urol, Shenzhen 518060, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Dept Urol, Shenzhen 518060, Guangdong, Peoples R China
3.Shenzhen Res & Dev Ctr Med Engn & Technol, Dept Urol Minimally Invas Urol, Shenzhen 518060, Guangdong, Peoples R China
4.Sun Yat Sen Univ, Affiliated Hosp 7, Dept Oncol, Shenzhen 518107, Guangdong, Peoples R China

Li, Zaishang,Li, Xueying,Liu, Ying,et al. Can American Joint Committee on Cancer prognostic groups be individualized in patients undergoing surgery for Stage IV invasive upper tract Urothelial Carcinoma?[J]. Journal of Cancer,2021,12(7).

Li, Zaishang,Li, Xueying,Liu, Ying,Fang, Jiequn,Zhang, Xueqi,&Xiao, Kefeng.(2021).Can American Joint Committee on Cancer prognostic groups be individualized in patients undergoing surgery for Stage IV invasive upper tract Urothelial Carcinoma?.Journal of Cancer,12(7).

Li, Zaishang,et al."Can American Joint Committee on Cancer prognostic groups be individualized in patients undergoing surgery for Stage IV invasive upper tract Urothelial Carcinoma?".Journal of Cancer 12.7(2021).