Balzano G, Bassi C, Zerbi A, Falconi M, Calori G, Butturini G, Leone B E, Pederzoli P, Di Carlo V
Department of Surgery, Borgoroma Hospital, Verona, Italy.
Int J Pancreatol. 1997 Apr;21(2):111-8. doi: 10.1007/BF02822382.
A different stage grouping of TNM factors can improve the predictivity of the UICC TNM classification for pancreatic cancer. Nevertheless, the Japanese Pancreas Society (JPS) classification maintains a higher prognostic value.
The use of a reliable staging classification facilitates the evaluation of anticancer treatments and the correct management of patients. The aim of the present study was to evaluate the prognostic value of three modified UICC TNM classifications, obtained by different stage grouping of the UICC TNM factors, comparing their predictivity to the standard UICC and the JPS classifications.
Clinical material consisted of 228 patients who underwent resection for pancreatic cancer. The reliability of the classifications was analyzed by the following methods: univariate analysis of stage survival curves; multivariate analysis of each classification after adjusting for grading and radicality; and correlation between the patients' distribution in the stages of each classification and in survival classes.
The following modified UICC classification allowed a better differentiation of stage II and III survival (P = 0.08) than standard UICC (P = 0.74): stage I: T1N0M0; stage II: T1N1M0/T2N0M0: stage III: T2N1M0/T3 any NM0; stage IV: M1. The JPS classification better discriminated between the different stages (P < 0.001). All classifications had an independent prognostic value by multivariate analysis. The correlation between stages and survival classes was higher for the JPS classification than either UICC TNM classification or the modified UICC classifications.
对TNM因素进行不同的分期分组可提高国际抗癌联盟（UICC）TNM分类对胰腺癌的预测性。然而，日本胰腺学会（JPS）分类仍具有更高的预后价值。
使用可靠的分期分类有助于评估抗癌治疗效果及对患者进行正确管理。本研究的目的是评估通过对UICC TNM因素进行不同分期分组得到的三种改良UICC TNM分类的预后价值，并将它们的预测性与标准UICC分类及JPS分类进行比较。
临床资料包括228例行胰腺癌切除术的患者。通过以下方法分析分类的可靠性：分期生存曲线的单因素分析；在调整分级和根治性后对每种分类进行多因素分析；以及每种分类的分期与生存类别中患者分布之间的相关性。
以下改良UICC分类比标准UICC分类能更好地区分II期和III期的生存率（P = 0.08，标准UICC分类P = 0.74）：I期：T1N0M0；II期：T1N1M0/T2N0M0；III期：T2N1M0/T3任何NM0；IV期：M1。JPS分类能更好地区分不同分期（P < 0.001）。通过多因素分析，所有分类均具有独立的预后价值。JPS分类的分期与生存类别之间的相关性高于UICC TNM分类或改良UICC分类。
