美国监测、流行病学和最终结果（SEER）登记处子宫体癌的特定部位因素：协作分期数据收集系统，第1版和第2版

Site-specific factors for cancer of the corpus uteri from SEER registries: collaborative stage data collection system, version 1 and version 2.

作者信息

Jamison Patricia M, Altekruse Sean F, Chang Joanne T, Zahn Jennifer, Lee Richard, Noone Anne-Michelle, Barroilhet Lisa

机构信息

National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, Maryland.

出版信息

Cancer. 2014 Dec 1;120 Suppl 23:3836-45. doi: 10.1002/cncr.29054.

DOI:10.1002/cncr.29054

PMID:25412395

Abstract

BACKGROUND

Uterine cancer is the fourth leading cancer among US women. Changes in uterine cancer staging were made from the American Joint Committee on Cancer (AJCC) 6th to 7th edition staging manuals, and 8 site-specific factors (SSFs) and 3 histologic schemas were introduced. Carcinomas account for 95% of cases and are the focus of this report.

METHODS

Distributions of SSF values were examined for 11,601 cases of malignant cancer of the corpus uteri and uterus, NOS (not otherwise specified) diagnosed in Surveillance, Epidemiology, and End Results (SEER) Program registries during 2010. AJCC 6th and 7th edition staging distributions were compared for 11,176 cases using data in both staging systems. AJCC 6th edition staging distributions during 2004-2010 were examined. AJCC 7th edition SSFs required by SEER were International Federation of Gynecology and Obstetrics stage (SSF1), peritoneal cytology (SSF2), number of positive pelvic lymph nodes (SSF3), number of pelvic lymph nodes examined (SSF4), number of positive para-aortic lymph nodes (SSF5), and number of para-aortic lymph nodes examined (SSF6).

RESULTS

For SSFs related to lymph nodes, a third of cases were classified as "not applicable," reflecting that lymph node dissection is not indicated for cases with stage1A and stage 4 diagnoses. AJCC 7th edition criteria assigned more cases to stage I (72.9%) than AJCC 6th edition criteria (68.7%). Annual counts significantly increased during 2004-2010, as did counts for AJCC 6th edition stages INOS, IA, IB, IC, IIIA, IIIB, IIIC, and IVB. The proportion of cases diagnosed with stage I cancer was stable, whereas stages II and IV decreased and stage III increased.

CONCLUSIONS

Five SSFs were suitable for analysis: peritoneal cytology results (SSF2), numbers of positive pelvic lymph nodes (SSF3), pelvic lymph nodes examined (SSF4), positive para-aortic lymph nodes (SSF5), and para-aortic lymph nodes examined (SSF6).

摘要

背景

子宫癌是美国女性中第四大常见癌症。美国癌症联合委员会（AJCC）癌症分期手册从第6版更新到第7版，引入了8个部位特异性因素（SSF）和3种组织学模式。在子宫癌病例中，95%为癌，本报告重点关注此类。

方法

对2010年监测、流行病学和最终结果（SEER）项目登记处诊断的11,601例子宫体恶性肿瘤及子宫恶性肿瘤（未另行说明）病例的SSF值分布进行了检查。利用两个分期系统的数据，对11,176例病例的AJCC第6版和第7版分期分布进行了比较。研究了2004 - 2010年期间AJCC第6版分期分布情况。SEER要求的AJCC第7版SSF包括国际妇产科联盟分期（SSF1）、腹腔细胞学检查结果（SSF2）、盆腔阳性淋巴结数目（SSF3）、盆腔检查的淋巴结数目（SSF4）、腹主动脉旁阳性淋巴结数目（SSF5）以及腹主动脉旁检查的淋巴结数目（SSF6）。

结果

对于与淋巴结相关的SSF，三分之一的病例被归类为“不适用”，这反映出对于I A期和IV期诊断的病例不建议进行淋巴结清扫。与AJCC第6版标准（68.7%）相比，AJCC第7版标准将更多病例归类为I期（72.9%）。2004 - 2010年期间，病例年度计数显著增加，AJCC第6版分期中的I NOS、I A、I B、I C、II I A、II I B、II I C和IV B期计数也显著增加。I期癌症诊断病例的比例保持稳定，而II期和IV期下降，III期上升。