Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma.
AJCC system
Bismuth system
Blumgart system
perihilar cholangiocarcinoma
tumor staging
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
revised:
11
09
2021
received:
21
07
2021
accepted:
26
09
2021
pubmed:
31
10
2021
medline:
26
7
2022
entrez:
30
10
2021
Statut:
ppublish
Résumé
Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma. Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter-based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell's concordance index (C-index). Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P < .001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P = .002, cT2 vs cT3; P = .008 and cT3 vs cT4; P < .001). The AJCC system had the largest C-index of 0.627. The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.
Sections du résumé
BACKGROUND
BACKGROUND
Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma.
METHODS
METHODS
Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter-based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell's concordance index (C-index).
RESULTS
RESULTS
Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P < .001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P = .002, cT2 vs cT3; P = .008 and cT3 vs cT4; P < .001). The AJCC system had the largest C-index of 0.627.
CONCLUSIONS
CONCLUSIONS
The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
768-777Informations de copyright
© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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