Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Oral Oncol. 2017 Sep;72:65-72. doi: 10.1016/j.oraloncology.2017.07.011.
We aimed to validate and compare the 7th and 8th edition of AJCC staging systems for non-metastatic nasopharyngeal carcinoma, and proposed staging systems from Hong Kong, Guangzhou, and Guangxi.
We retrospectively included 899 patients treated between November 5, 2002 and May 27, 2010. Separation and discrimination of each staging system in overall survival were primarily compared.
Compared with the 7th AJCC, the 8th AJCC and all proposed staging systems well separated across T-classification. T-classification from Guangzhou seemed to perform best in discrimination (C-index 0.6454), followed by the 8th AJCC (0.6451), the 7th AJCC (0.6386), Hong Kong (0.6376) and Guangxi (0.5889). For N-classification, no staging systems improved the weakness of the 7th AJCC in separating N2 and N1, except that suggestion from Guangzhou showed higher potential (P=0.096). Besides, N-classification from Guangzhou had a C-index of 0.6444, larger than that of the 8th AJCC (0.6235), the 7th AJCC (0.6179), Hong Kong (0.6175) and Guangxi (0.6175). Accordingly, stage group of staging system from Guangzhou showed higher discrimination (C-index 0.6839), compared with the 8th AJCC (0.6791), the 7th AJCC (0.6766), Hong Kong (0.6765) and Guangxi (0.6688), despite that stage I and II remained inseparable (P=0.322).
The 8th AJCC staging system appeared to be better than the 7th AJCC. But the proposed staging system from Guangzhou was more likely to improve the separation and discrimination abilities.
本研究旨在验证和比较第七版和第八版 AJCC 分期系统在非转移性鼻咽癌中的应用，并提出来自香港、广州和广西的分期系统。
本研究回顾性纳入了 2002 年 11 月 5 日至 2010 年 5 月 27 日期间接受治疗的 899 例患者。首先比较了每个分期系统在总生存中的分离和判别能力。
与第七版 AJCC 相比，第八版 AJCC 和所有提出的分期系统在 T 分期分类方面均有较好的分离。广州的 T 分期分类在判别能力方面表现最佳（C 指数为 0.6454），其次是第八版 AJCC（0.6451）、第七版 AJCC（0.6386）、香港（0.6376）和广西（0.5889）。对于 N 分期，除了广州的建议外，没有任何分期系统能够改善第七版 AJCC 在区分 N2 和 N1 方面的不足（P=0.096）。此外，广州的 N 分期分类的 C 指数为 0.6444，大于第八版 AJCC（0.6235）、第七版 AJCC（0.6179）、香港（0.6175）和广西（0.6175）。因此，与第八版 AJCC（0.6791）、第七版 AJCC（0.6766）、香港（0.6765）和广西（0.6688）相比，广州分期系统的分期组显示出更高的判别能力（C 指数为 0.6839），尽管 I 期和 II 期仍然无法区分（P=0.322）。
第八版 AJCC 分期系统似乎优于第七版 AJCC。但来自广州的分期系统更有可能提高分期的分离和判别能力。
