American Joint Committee on Cancer staging for resected perihilar cholangiocarcinoma: a comparison of the 6th and 7th editions.

[cholangiocarcinoma]

This study was conducted to evaluate the prognostic value of , respectively , the 6 th and 7 th editions of the American Joint Committee on Cancer (AJCC ) staging system for patients with resected perihilar cholangiocarcinoma (PHC ).Patients who underwent resection of PHC between 1991 and 2012 were identified from prospective databases at two centres . Overall survival was estimated using the Kaplan-Meier method and compared across stage groups with the log-rank test . The concordance index and Brier score were used to compare the prognostic accuracy of the staging systems .Data for a total of 306 patients were analysed . Staging according to the 7 th edition upstaged 63 % of patients in comparison with staging by the 6 th edition . The log-rank P-value for both staging systems was highly statistically significant (P < 0 .001 ). Staging according to the 6 th edition categorized 93 % of patients as having stage I or II disease , whereas staging according to the 7 th edition distributed patients more equally across stages . Prognostic accuracy was similar between the staging systems : the concordance index was 0 .59 and the Brier score 0 .17 for both the 6 th and 7 th editions . The same prognostic accuracy was achieved using an alternative tumour-node-metastasis (TNM ) stage grouping simplified to four rather than six stage groups .The 6 th and 7 th editions of the AJCC staging system for PHC have similar prognostic accuracy . Other prognostic factors can potentially improve individual patient prognostication .

Diseases
Validation

Diseases presenting "cancer" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

alpha-thalassemia

benign recurrent intrahepatic cholestasis

cadasil

canavan disease

carcinoma of the gallbladder

cholangiocarcinoma

coats disease

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cowden syndrome

cushing syndrome

cutaneous mastocytosis

dedifferentiated liposarcoma

dystrophic epidermolysis bullosa

epidermolysis bullosa simplex

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

esophageal carcinoma

esophageal squamous cell carcinoma

familial hypocalciuric hypercalcemia

familial mediterranean fever

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

hirschsprung disease

hodgkin lymphoma, classical

inclusion body myositis

junctional epidermolysis bullosa

kabuki syndrome

kallmann syndrome

kindler syndrome

lamellar ichthyosis

liposarcoma

locked-in syndrome

lymphangioleiomyomatosis

monosomy 21

neuralgic amyotrophy

oculocutaneous albinism

oligodontia

oral submucous fibrosis

papillon-lefèvre syndrome

pendred syndrome

pleomorphic liposarcoma

primary effusion lymphoma

proteus syndrome

pyomyositis

pyruvate dehydrogenase deficiency

severe combined immunodeficiency

sneddon syndrome

systemic capillary leak syndrome

triple a syndrome

von hippel-lindau disease

waldenström macroglobulinemia

well-differentiated liposarcoma

werner syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

This symptom has already been validated