Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Colorectal Dis. 2011 Aug;13(8):e220-6. doi: 10.1111/j.1463-1318.2011.02625.x.
The sixth and seventh editions of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) system for patients with stage II and stage III colorectal carcinoma (AJCC-6 and AJCC-7) were compared.
Between 2000 and 2007, 2511 stage II/III colorectal carcinoma patients received primary surgical resection at the Asan Medical Center (Seoul, Korea). All patients were staged using AJCC-6 and AJCC-7 TNM systems. Patients with synchronous or other cancers, those given preoperative chemotherapy or radiotherapy and those in whom fewer than 12 lymph nodes were resected, were excluded. Overall survival (OS) and disease-free survival (DFS) were compared.
Of 2511 patients, 255 (10.2%) had different stages in the AJCC-6 and AJCC-7. For the AJCC-7, the 5-year OS by stage was 94.2% for stage IIA, 88.8% for stage IIB, 83.5% for stage IIC, 91.8% for stage IIIA, 81.8% for stage IIIB and 72.0% for stage IIIC. The OS and the DFS were not significantly different for the new substages IIB (n = 57) and IIC (n = 34) (P = 0.34 and P = 0.87, respectively). For the 187 patients with stage T3N2a cancer, the OS and the DFS were significantly different from stage IIIB other than T3N2a (P = 0.008 and P = 0.01, respectively) and there were no statistically significant differences in OS between the T3N2a group and the IIIC group (P = 0.46).
The study indicates that AJCC-7 has better prognostic validity than AJCC-6 for staging of patients with stage II and stage III colorectal carcinoma.
比较第 6 版和第 7 版美国癌症联合委员会（AJCC）肿瘤-淋巴结-转移（TNM）分期系统在 II 期和 III 期结直肠癌患者中的应用（AJCC-6 和 AJCC-7）。
2000 年至 2007 年，2511 例 II/III 期结直肠癌患者在韩国首尔的 Asan 医疗中心接受了根治性手术。所有患者均采用 AJCC-6 和 AJCC-7 TNM 系统分期。排除同时性或其他部位癌症、术前化疗或放疗以及淋巴结切除少于 12 枚的患者。比较总生存（OS）和无病生存（DFS）。
2511 例患者中，255 例（10.2%）在 AJCC-6 和 AJCC-7 中的分期不同。对于 AJCC-7，按分期的 5 年 OS 为 IIA 期 94.2%、IIB 期 88.8%、IIC 期 83.5%、IIIA 期 91.8%、IIIB 期 81.8%和 IIIC 期 72.0%。新亚分期 IIB（n = 57）和 IIC（n = 34）之间的 OS 和 DFS 差异无统计学意义（P = 0.34 和 P = 0.87）。对于 187 例 T3N2a 期癌症患者，与 T3N2a 以外的 IIIB 期相比，OS 和 DFS 差异有统计学意义（P = 0.008 和 P = 0.01），T3N2a 组与 IIIC 组之间 OS 差异无统计学意义（P = 0.46）。
该研究表明，与 AJCC-6 相比，AJCC-7 对 II 期和 III 期结直肠癌患者的分期具有更好的预后价值。
