Toward better soft tissue sarcoma staging: Building on american joint committee on cancer staging systems versions 6 and 7 Journal Article
| Authors: | Maki, R. G.; Moraco, N.; Antonescu, C. R.; Hameed, M.; Pinkhasik, A.; Singer, S.; Brennan, M. F. |
| Article Title: | Toward better soft tissue sarcoma staging: Building on american joint committee on cancer staging systems versions 6 and 7 |
| Abstract: | Background: Based on review of patient data in case conferences over time, we hypothesized that clinically relevant data are omitted in routine soft tissue sarcoma staging. Methods: We examined subsets of a prospectively collected single institution soft tissue sarcoma database with respect to criteria of the AJCC versions 6 (2002) and 7 (2010) staging systems and examined their clinical outcomes. Results: Relapse-free survival decreases with increasing primary tumor size in four categories, versus two categories used in AJCC 6 and 7 staging. Disease-specific survival decreases over three categories. Conversely, omission of tumor depth as a prognostic factor in version 7 appears supported, since tumor depth is not an independent risk factor for disease-specific survival by multivariate analysis. Patients with nodal disease and no other metastases fare better than patients with other metastases, but have inferior outcomes compared with patients with large high-grade tumors without nodal metastasis. Multivariate analysis identified size, site, grade, age, nodal metastatic disease, and other metastatic disease as independent risk factors for disease-specific survival. Versions 6 and 7 criteria are tacit regarding anatomic site and histology for tumors with identical FNCLCC grade. Conclusions: Improved patient risk assessment may be achieved by staging using a larger number of size categories. Staging system refinements come at the cost of a larger number of staging categories. Histology or site-specific staging systems, nomograms or Bayesian belief networks may provide more accurate means to assess clinical outcomes. © 2013 Society of Surgical Oncology. Reference:. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 20 |
| Issue: | 11 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2013-10-01 |
| Start Page: | 3377 |
| End Page: | 3383 |
| Language: | English |
| DOI: | 10.1245/s10434-013-3052-0 |
| PROVIDER: | scopus |
| PUBMED: | 23775410 |
| PMCID: | PMC4067483 |
| DOI/URL: | |
| Notes: | --- - Cited By (since 1996):1 - "Export Date: 1 October 2013" - "CODEN: ASONF" - "Source: Scopus" |
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