Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database
The 8th American Joint Committee on Cancer (AJCC) staging system for distal cholangiocarcinoma (DCC) included a positive lymph node count (PLNC), but a comparison of the prognostic predictive power of PLNC and lymph node ratio (LNR) is still under debate. This study aimed to compare various staging...
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doaj-f2784569c31c4baa8c0e8bdea6a893dd2020-11-25T01:38:07ZengMDPI AGCancers2072-66942020-03-0112376210.3390/cancers12030762cancers12030762Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter DatabaseYunghun You0Yong Chan Shin1Dong Wook Choi2Jin Seok Heo3Sang Hyun Shin4Naru Kim5Kee-Taek Jang6Hongbeom Kim7Chang-Sup Lim8Sun Hee Chang9Kang Min Han10In Woong Han11Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Seoul National University College of Medicine, Seoul 03080, KoreaDepartment of Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, KoreaDepartment of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, KoreaDepartment of Pathology, Dongguk University Ilsan Hospital, Goyang 10326, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaThe 8th American Joint Committee on Cancer (AJCC) staging system for distal cholangiocarcinoma (DCC) included a positive lymph node count (PLNC), but a comparison of the prognostic predictive power of PLNC and lymph node ratio (LNR) is still under debate. This study aimed to compare various staging models made by combining the abovementioned factors, identify the model with the best predictive power, and propose a modified staging system. We retrospectively reviewed 251 patients who underwent surgery for DCC at four centers. To determine the superiority of various staging models for predicting overall OSR, Akaike information criterion (AIC), Bayesian information criterion (BIC), AIC correction (AICc), and Harrell’s C-statistic were calculated. In multivariate analysis, age (<i>p</i> = 0.003), total lymph node count (<i>p</i> = 0.033), and revised T(LNR)M staging (<i>p</i> < 0.001) were identified as independent factors for overall survival rate. The predictive performance of revised T (LNR) M staging (AIC: 1288.925, BIC: 1303.377, AICc: 1291.52, and Harrell’s C statics: 0.667) was superior to other staging system. A modified staging system consisting of revised T category and LNR predicted better overall survival of DCC than AJCC 7th and AJCC 8th editions. In the future, external validation of the proposed new system using a larger cohort will be required.https://www.mdpi.com/2072-6694/12/3/762american joint committee on cancer 8th editiondistal cholangiocarcinomamodification of stagingvalidation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yunghun You Yong Chan Shin Dong Wook Choi Jin Seok Heo Sang Hyun Shin Naru Kim Kee-Taek Jang Hongbeom Kim Chang-Sup Lim Sun Hee Chang Kang Min Han In Woong Han |
spellingShingle |
Yunghun You Yong Chan Shin Dong Wook Choi Jin Seok Heo Sang Hyun Shin Naru Kim Kee-Taek Jang Hongbeom Kim Chang-Sup Lim Sun Hee Chang Kang Min Han In Woong Han Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database Cancers american joint committee on cancer 8th edition distal cholangiocarcinoma modification of staging validation |
author_facet |
Yunghun You Yong Chan Shin Dong Wook Choi Jin Seok Heo Sang Hyun Shin Naru Kim Kee-Taek Jang Hongbeom Kim Chang-Sup Lim Sun Hee Chang Kang Min Han In Woong Han |
author_sort |
Yunghun You |
title |
Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database |
title_short |
Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database |
title_full |
Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database |
title_fullStr |
Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database |
title_full_unstemmed |
Proposed Modification of Staging for Distal Cholangiocarcinoma Based on the Lymph Node Ratio Using Korean Multicenter Database |
title_sort |
proposed modification of staging for distal cholangiocarcinoma based on the lymph node ratio using korean multicenter database |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-03-01 |
description |
The 8th American Joint Committee on Cancer (AJCC) staging system for distal cholangiocarcinoma (DCC) included a positive lymph node count (PLNC), but a comparison of the prognostic predictive power of PLNC and lymph node ratio (LNR) is still under debate. This study aimed to compare various staging models made by combining the abovementioned factors, identify the model with the best predictive power, and propose a modified staging system. We retrospectively reviewed 251 patients who underwent surgery for DCC at four centers. To determine the superiority of various staging models for predicting overall OSR, Akaike information criterion (AIC), Bayesian information criterion (BIC), AIC correction (AICc), and Harrell’s C-statistic were calculated. In multivariate analysis, age (<i>p</i> = 0.003), total lymph node count (<i>p</i> = 0.033), and revised T(LNR)M staging (<i>p</i> < 0.001) were identified as independent factors for overall survival rate. The predictive performance of revised T (LNR) M staging (AIC: 1288.925, BIC: 1303.377, AICc: 1291.52, and Harrell’s C statics: 0.667) was superior to other staging system. A modified staging system consisting of revised T category and LNR predicted better overall survival of DCC than AJCC 7th and AJCC 8th editions. In the future, external validation of the proposed new system using a larger cohort will be required. |
topic |
american joint committee on cancer 8th edition distal cholangiocarcinoma modification of staging validation |
url |
https://www.mdpi.com/2072-6694/12/3/762 |
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