Department of Pathology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania.
Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania.
J Gastrointest Cancer. 2021 Mar;52(1):243-248. doi: 10.1007/s12029-020-00394-z.
We aimed to emphasize the prognostic impact of differences included in the 8th versus the previous 7th edition of AJCC (American Joint Committee on Cancer) Cancer Staging manual for hepatocellular carcinoma (HCC).
A number of 87 consecutive HCCs were retrospectively evaluated and staged, using the 7th and 8th edition of AJCC staging systems. The clinicopathological parameters were correlated with the overall survival rate. No preoperative chemotherapy was received by any of the patients.
According to the 7th edition of AJCC manual, 52 of the 87 cases were staged as pT2 and 35 as pT1. After restaging, according to the 8th edition, 23 of the 52 pT2 cases were understaged as pT1b, and the rest of the 29 remained as pT2. Regarding the 35 HCCs classified as pT1, using 7th edition, all of them were restaged as pT1a. Compared to the 7th staging system, using the 8th edition of AJCC manual, the percentage of pT2 tumors significantly decreased, from 59.77 to 33.33%. The patient's gender, age, tumor focality, and grade of differentiation did not prove to have any prognostic value. Regarding pT stage, it does not influence the overall survival rate, independently from the used staging system.
The staging criteria, in the most recent edition of AJCC, are simplified and allowed tumor understaging. These changes do not have independent prognostic value. The prognostic impact of pT understaging should be evaluated in larger cohorts.
我们旨在强调第 8 版与之前的第 7 版 AJCC（美国癌症联合委员会）癌症分期手册在肝细胞癌（HCC）中的差异对预后的影响。
回顾性评估了 87 例连续 HCC 病例，并使用第 7 版和第 8 版 AJCC 分期系统进行分期。将临床病理参数与总生存率相关联。所有患者均未接受术前化疗。
根据第 7 版 AJCC 手册，87 例中有 52 例分期为 pT2，35 例分期为 pT1。根据第 8 版重新分期后，52 例 pT2 中有 23 例被低估为 pT1b，其余 29 例仍为 pT2。对于使用第 7 版分类为 pT1 的 35 例 HCC，所有病例均被重新分期为 pT1a。与第 7 个分期系统相比，使用第 8 版 AJCC 手册，pT2 肿瘤的比例从 59.77%显著下降至 33.33%。患者的性别、年龄、肿瘤局灶性和分化程度均未证明具有任何预后价值。对于 pT 分期，它并不影响总体生存率，与所使用的分期系统无关。
最新版 AJCC 的分期标准得到简化，并允许肿瘤被低估分期。这些变化没有独立的预后价值。pT 低估分期的预后影响应在更大的队列中进行评估。
