在美国癌症联合委员会（第 8 版）胰腺癌分期系统中，III 期应进一步细分为 IIIA 期和 IIIB 期。
Stage III should be subclassified into Stage IIIA and IIIB in the American Joint Committee on Cancer (8 Edition) staging system for pancreatic cancer.
机构信息
Department of General Surgery, Tianjin First Central Hospital, Tianjin 300192, China.
Department of Surgery, Tianjin Second People's Hospital, Tianjin 300192, China.
出版信息
World J Gastroenterol. 2018 Jun 14;24(22):2400-2405. doi: 10.3748/wjg.v24.i22.2400.
AIM
To ascertain the prognostic role of the T4 and N2 category in stage III pancreatic cancer according to the 8 edition of the American Joint Committee on Cancer (AJCC) classification.
METHODS
Patients were collected from the Surveillance Epidemiology and End Results (SEER) database (2004-2013) and were divided into three groups: T(1-3)N2, T4N(0-1), and T4N2. Overall survival (OS) and disease-specific survival (DSS) of patients were evaluated by the Kaplan-Meier method.
RESULTS
For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4N(0-1) and T4N2 but not between T(1-3)N2 and T4N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4N2 groups.
CONCLUSION
Patients with stage T4N2 had a worse prognosis than those with stage T(1-3)N2/T4N(0-1) in the 8 edition AJCC staging system for pancreatic cancer. We recommend that stage III should be subclassified into stage IIIA [T(1-3)N2/T4N(0-1)] and stage IIIB (T4N2).
目的
根据第 8 版美国癌症联合委员会（AJCC）分类，确定 T4 和 N2 分期在 III 期胰腺癌中的预后作用。
方法
从监测、流行病学和最终结果（SEER）数据库（2004-2013 年）中收集患者，并将其分为三组：T（1-3）N2、T4N（0-1）和 T4N2。通过 Kaplan-Meier 法评估患者的总生存率（OS）和疾病特异性生存率（DSS）。
结果
我们首次发现 OS 和 DSS 在 T（1-3）N2/T4N（0-1）和 T4N2 之间存在显著差异，但在 T（1-3）N2 和 T4N（0-1）之间无差异。较高的分级与 T（1-3）N2 和 T4N2 组的预后较差相关。
结论
在第 8 版 AJCC 胰腺癌分期系统中，T4N2 期患者的预后比 T（1-3）N2/T4N（0-1）期患者差。我们建议将 III 期进一步细分为 IIIA 期[T（1-3）N2/T4N（0-1）]和 IIIB 期（T4N2）。
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