Evaluation of Prostate Cancer Stage Groups Updated in the 8th Edition of the American Joint Committee on Cancer Tumor–Node–Metastasis Staging Manual

Hakmin Lee, Minseung Lee, Seok Soo Byun, Sang Eun Lee, Sung Kyu Hong

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Abstract

Introduction: The American Joint Committee on Cancer (AJCC) tumor, node, metastasis classification system (TNM) staging manual has been updated and provides more specified stage grouping for prostate cancer (PCa). We aimed to validate the updated AJCC stage groups for PCa using a radical prostatectomy (RP) cohort. Patients and Methods: We analyzed the data of 3032 patients previously treated with RP for localized PCa. We stratified patients into stage groups according to the 8th edition of the AJCC manual and compared biochemical recurrence (BCR)-free survival using Kaplan-Meier analyses. Results: There were 217 patients in stage group I, 33 in IIA, 1101 in IIB, 535 in IIC, 129 in IIIA, 781 in IIIB, and 236 in IIIC. There were no significant differences in BCR-free survival between stage groups IIC and IIIA (P =.875). Subsequently, the low–Gleason score (GS) IIIA subgroup (GS ≤ 3 + 4, P =.025) showed superior BCR-free survival than the IIC group, and the high-GS IIIA subgroups (GS ≥ 4 + 3, P =.004) showed a poorer BCR-free survival than the IIC group. Furthermore, there were no significant differences between groups I and IIA (P = 330) and between groups IIA and IIB (P =.942). Our new staging system provided a better ability to discriminate the prognosis of each group. However, our study has several limitations, such as retrospective design, relatively short follow-up period, and need for further validation. Conclusion: The current AJCC prognostic groups show some contradictory results, particularly concerning prognosis of the IIC and IIIA groups. We suggest that GS be given more weight than serum prostate-specific antigen level in stage group stratification.

Original languageEnglish
Pages (from-to)e221-e226
JournalClinical Genitourinary Cancer
Volume17
Issue number1
DOIs
StatePublished - Feb 2019

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Neoplasm Staging
Prostatic Neoplasms
Recurrence
Survival
Neoplasms
Prostatectomy
Kaplan-Meier Estimate
Prostate-Specific Antigen
Neoplasm Metastasis
Weights and Measures
Serum

Keywords

  • AJCC prognosis group
  • Biochemical recurrence
  • Prostate cancer
  • Prostate-specific antigen
  • Prostatectomy

Cite this

@article{7f5e854fafae42388c3afdbb437ab8fb,
title = "Evaluation of Prostate Cancer Stage Groups Updated in the 8th Edition of the American Joint Committee on Cancer Tumor–Node–Metastasis Staging Manual",
abstract = "Introduction: The American Joint Committee on Cancer (AJCC) tumor, node, metastasis classification system (TNM) staging manual has been updated and provides more specified stage grouping for prostate cancer (PCa). We aimed to validate the updated AJCC stage groups for PCa using a radical prostatectomy (RP) cohort. Patients and Methods: We analyzed the data of 3032 patients previously treated with RP for localized PCa. We stratified patients into stage groups according to the 8th edition of the AJCC manual and compared biochemical recurrence (BCR)-free survival using Kaplan-Meier analyses. Results: There were 217 patients in stage group I, 33 in IIA, 1101 in IIB, 535 in IIC, 129 in IIIA, 781 in IIIB, and 236 in IIIC. There were no significant differences in BCR-free survival between stage groups IIC and IIIA (P =.875). Subsequently, the low–Gleason score (GS) IIIA subgroup (GS ≤ 3 + 4, P =.025) showed superior BCR-free survival than the IIC group, and the high-GS IIIA subgroups (GS ≥ 4 + 3, P =.004) showed a poorer BCR-free survival than the IIC group. Furthermore, there were no significant differences between groups I and IIA (P = 330) and between groups IIA and IIB (P =.942). Our new staging system provided a better ability to discriminate the prognosis of each group. However, our study has several limitations, such as retrospective design, relatively short follow-up period, and need for further validation. Conclusion: The current AJCC prognostic groups show some contradictory results, particularly concerning prognosis of the IIC and IIIA groups. We suggest that GS be given more weight than serum prostate-specific antigen level in stage group stratification.",
keywords = "AJCC prognosis group, Biochemical recurrence, Prostate cancer, Prostate-specific antigen, Prostatectomy",
author = "Hakmin Lee and Minseung Lee and Byun, {Seok Soo} and Lee, {Sang Eun} and Hong, {Sung Kyu}",
year = "2019",
month = "2",
doi = "10.1016/j.clgc.2018.10.015",
language = "English",
volume = "17",
pages = "e221--e226",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Evaluation of Prostate Cancer Stage Groups Updated in the 8th Edition of the American Joint Committee on Cancer Tumor–Node–Metastasis Staging Manual

AU - Lee, Hakmin

AU - Lee, Minseung

AU - Byun, Seok Soo

AU - Lee, Sang Eun

AU - Hong, Sung Kyu

PY - 2019/2

Y1 - 2019/2

N2 - Introduction: The American Joint Committee on Cancer (AJCC) tumor, node, metastasis classification system (TNM) staging manual has been updated and provides more specified stage grouping for prostate cancer (PCa). We aimed to validate the updated AJCC stage groups for PCa using a radical prostatectomy (RP) cohort. Patients and Methods: We analyzed the data of 3032 patients previously treated with RP for localized PCa. We stratified patients into stage groups according to the 8th edition of the AJCC manual and compared biochemical recurrence (BCR)-free survival using Kaplan-Meier analyses. Results: There were 217 patients in stage group I, 33 in IIA, 1101 in IIB, 535 in IIC, 129 in IIIA, 781 in IIIB, and 236 in IIIC. There were no significant differences in BCR-free survival between stage groups IIC and IIIA (P =.875). Subsequently, the low–Gleason score (GS) IIIA subgroup (GS ≤ 3 + 4, P =.025) showed superior BCR-free survival than the IIC group, and the high-GS IIIA subgroups (GS ≥ 4 + 3, P =.004) showed a poorer BCR-free survival than the IIC group. Furthermore, there were no significant differences between groups I and IIA (P = 330) and between groups IIA and IIB (P =.942). Our new staging system provided a better ability to discriminate the prognosis of each group. However, our study has several limitations, such as retrospective design, relatively short follow-up period, and need for further validation. Conclusion: The current AJCC prognostic groups show some contradictory results, particularly concerning prognosis of the IIC and IIIA groups. We suggest that GS be given more weight than serum prostate-specific antigen level in stage group stratification.

AB - Introduction: The American Joint Committee on Cancer (AJCC) tumor, node, metastasis classification system (TNM) staging manual has been updated and provides more specified stage grouping for prostate cancer (PCa). We aimed to validate the updated AJCC stage groups for PCa using a radical prostatectomy (RP) cohort. Patients and Methods: We analyzed the data of 3032 patients previously treated with RP for localized PCa. We stratified patients into stage groups according to the 8th edition of the AJCC manual and compared biochemical recurrence (BCR)-free survival using Kaplan-Meier analyses. Results: There were 217 patients in stage group I, 33 in IIA, 1101 in IIB, 535 in IIC, 129 in IIIA, 781 in IIIB, and 236 in IIIC. There were no significant differences in BCR-free survival between stage groups IIC and IIIA (P =.875). Subsequently, the low–Gleason score (GS) IIIA subgroup (GS ≤ 3 + 4, P =.025) showed superior BCR-free survival than the IIC group, and the high-GS IIIA subgroups (GS ≥ 4 + 3, P =.004) showed a poorer BCR-free survival than the IIC group. Furthermore, there were no significant differences between groups I and IIA (P = 330) and between groups IIA and IIB (P =.942). Our new staging system provided a better ability to discriminate the prognosis of each group. However, our study has several limitations, such as retrospective design, relatively short follow-up period, and need for further validation. Conclusion: The current AJCC prognostic groups show some contradictory results, particularly concerning prognosis of the IIC and IIIA groups. We suggest that GS be given more weight than serum prostate-specific antigen level in stage group stratification.

KW - AJCC prognosis group

KW - Biochemical recurrence

KW - Prostate cancer

KW - Prostate-specific antigen

KW - Prostatectomy

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U2 - 10.1016/j.clgc.2018.10.015

DO - 10.1016/j.clgc.2018.10.015

M3 - Article

C2 - 30472041

AN - SCOPUS:85056903104

VL - 17

SP - e221-e226

JO - Clinical Genitourinary Cancer

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