第八届美国癌症解剖和预后分期联合委员会对阴茎癌的预后价值：一项多中心合作研究

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2025-01-01 DOI:10.1016/j.ajur.2024.10.001

Xueying Li , Yepeng Guo , Antonio Augusto Ornellas , Jiun-Hung Geng , Yonghong Li , Wayne Lam , Yabing Cao , Zhuowei Liu , Hui Han , Fangjian Zhou , Zaishang Li

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引用次数: 0

摘要

目的探讨第8届美国癌症联合委员会（AJCC）阴茎癌患者解剖及预后分期分类的价值，并探讨是否有改进的余地。方法对2000年1月至2021年12月16个中心的临床和组织病理学资料进行评估，并按AJCC第8期解剖和预后分期分组。Kaplan-Meier图用于估计患者的疾病特异性生存（DSS）。采用Harrell’s concordance index （C-index）对分期系统的准确性进行了研究。结果根据AJCC第8个解剖和预后分期分组，0is/a、I、IIA、IIB、IIIA、IIIB和IV期疾病患者的5年DSS率分别为100%、99%、86%、81%、66%、34%和23% （p0is/a - I=0.8, pI-IIA<0.001, pIIA-IIB =0.5, piib - IIA<0.001, pIIIB-IV =0.004, pTotal<0.001）。根据改进的模型1系统，0期I /a、I、II、IIIA、IIIB和IV期患者的5年无生存重叠DSS率分别为100%、99%、88%、66%、34%和23% （p0is/a - I=0.8, pI-II<0.001, pII-IIIA =0.002, pIIIA-IIIB<0.001, pIIIB-IV =0.004, pTotal<0.001）。同样，根据改进的模型2系统，0is/a、I、II、IIIA、IIIB和IV期患者无生存重叠的5年DSS率分别为100%、99%、86%、66%、34%和23% （p0is/a - I=0.8, pI-II<0.001, pII-IIIA =0.008, pIIIA-IIIB<0.001, pIIIB-IV =0.004, pTotal<0.001）。简单改良分期系统的c指数评分不低于AJCC解剖和预后分期组。这些结果被bootstrap内部验证所证实。结论AJCC的第8个解剖分期和预后分期仍有改进的空间。改进后的模型更简洁、方便，预测精度相近。

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The prognostic value of the 8th American Joint Committee on cancer anatomic and prognostic stage groups for penile cancer: A multicenter collaboration study

Objective

The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer (AJCC) anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.

Methods

The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups. Kaplan–Meier plots were used to estimate the disease-specific survival (DSS) of the patients. The accuracy of the staging systems was investigated using the Harrell's concordance index (C-index).

Results

According to the 8th AJCC anatomic and prognostic stage groups, the 5-year DSS rates for patients with stages 0is/a, I, IIA, IIB, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 81%, 66%, 34%, and 23%, respectively (p_0is/a–I=0.8, p_I–IIA<0.001, p_IIA–IIB=0.5, p_IIB–IIIA<0.001, p_IIIA–IIIB<0.001, p_IIIB–IV=0.004, and p_Total<0.001). According to the modified model 1 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 88%, 66%, 34%, and 23%, respectively (p_0is/a–I=0.8, p_I–II<0.001, p_II–IIIA=0.002, p_IIIA–IIIB<0.001, p_IIIB–IV=0.004, and p_Total<0.001). Similarly, according to the modified model 2 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 66%, 34%, and 23%, respectively (p_0is/a–I=0.8, p_I–II<0.001, p_II–IIIA=0.008, p_IIIA–IIIB<0.001, p_IIIB–IV=0.004, and p_Total<0.001). The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups. These results were confirmed by the bootstrap internal validation.

Conclusion

There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups. The improved models, which are more concise and convenient, have similar prediction accuracy.

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.