Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma
Background Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma. Methods Patients who were treated for pe...
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| Veröffentlicht in: | Journal of hepato-biliary-pancreatic sciences 2022-07, Vol.29 (7), p.768-777 |
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| creator | Yamada, Mihoko Mizuno, Takashi Yamaguchi, Junpei Yokoyama, Yukihiro Igami, Tsuyoshi Onoe, Shunsuke Watanabe, Nobuyuki Uehara, Kay Matsuo, Keitaro Ebata, Tomoki |
| description | Background
Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma.
Methods
Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter‐based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell’s concordance index (C‐index).
Results
Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P |
| doi_str_mv | 10.1002/jhbp.1066 |
| format | Article |
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Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma.
Methods
Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter‐based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell’s concordance index (C‐index).
Results
Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P < .001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P = .002, cT2 vs cT3; P = .008 and cT3 vs cT4; P < .001). The AJCC system had the largest C‐index of 0.627.
Conclusions
The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.
Yamada and colleagues revealed the American Joint Committee on Cancer (AJCC) tumor classification system to be the optimal clinical staging system in perihilar cholangiocarcinoma for predicting resectability and long‐term survival probability. Their findings provide clear evidence to stage local tumor extension using the AJCC system prior to definitive treatment.</description><identifier>ISSN: 1868-6974</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.1066</identifier><language>eng</language><publisher>Tokyo: Wiley Subscription Services, Inc</publisher><subject>AJCC system ; Bismuth system ; Blumgart system ; Cholangiocarcinoma ; Classification ; perihilar cholangiocarcinoma ; tumor staging ; Tumors</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2022-07, Vol.29 (7), p.768-777</ispartof><rights>2021 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.</rights><rights>Copyright © 2022 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3546-3f6f857fd6f0041460f8c8c601009445263937b2172df3022642120a589761753</citedby><cites>FETCH-LOGICAL-c3546-3f6f857fd6f0041460f8c8c601009445263937b2172df3022642120a589761753</cites><orcidid>0000-0001-6362-2243 ; 0000-0002-8247-7050 ; 0000-0003-2385-5610</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjhbp.1066$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjhbp.1066$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids></links><search><creatorcontrib>Yamada, Mihoko</creatorcontrib><creatorcontrib>Mizuno, Takashi</creatorcontrib><creatorcontrib>Yamaguchi, Junpei</creatorcontrib><creatorcontrib>Yokoyama, Yukihiro</creatorcontrib><creatorcontrib>Igami, Tsuyoshi</creatorcontrib><creatorcontrib>Onoe, Shunsuke</creatorcontrib><creatorcontrib>Watanabe, Nobuyuki</creatorcontrib><creatorcontrib>Uehara, Kay</creatorcontrib><creatorcontrib>Matsuo, Keitaro</creatorcontrib><creatorcontrib>Ebata, Tomoki</creatorcontrib><title>Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma</title><title>Journal of hepato-biliary-pancreatic sciences</title><description>Background
Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma.
Methods
Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter‐based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell’s concordance index (C‐index).
Results
Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P < .001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P = .002, cT2 vs cT3; P = .008 and cT3 vs cT4; P < .001). The AJCC system had the largest C‐index of 0.627.
Conclusions
The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.
Yamada and colleagues revealed the American Joint Committee on Cancer (AJCC) tumor classification system to be the optimal clinical staging system in perihilar cholangiocarcinoma for predicting resectability and long‐term survival probability. Their findings provide clear evidence to stage local tumor extension using the AJCC system prior to definitive treatment.</description><subject>AJCC system</subject><subject>Bismuth system</subject><subject>Blumgart system</subject><subject>Cholangiocarcinoma</subject><subject>Classification</subject><subject>perihilar cholangiocarcinoma</subject><subject>tumor staging</subject><subject>Tumors</subject><issn>1868-6974</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LAzEQhoMoWGoP_oOAFz3U5muz2WNd1FoKCtZzSNPEpuxu1mQX6b83a8WD4FxmGJ6ZeecF4BKjW4wQme13mzZVnJ-AERZcTHkhyOlvnbNzMIlxj1JQTAuKRqB67VsTnA-uO0Bvoa5c47Sq4LxOba0auPSu6WDp69p1nTHQN7BUjTYBrhOtYnQ2cZ1LfesDHLbtXKUC1Dtfqebdea2Cdo2v1QU4s6qKZvKTx-Dt4X5dLqar58encr6aapoxPqWWW5HldsstQgwzjqzQQnOUniwYywhP2vMNwTnZWooI4YxgglQmipzjPKNjcH3c2wb_0ZvYydpFbaokx_g-SpIVCAmCGE3o1R907_vQJHWS5CSdzCgVibo5Ujr4GIOxsg2uVuEgMZKD9XKwXg7WJ3Z2ZD9dZQ7_g3K5uHv5nvgCvceD7A</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Yamada, Mihoko</creator><creator>Mizuno, Takashi</creator><creator>Yamaguchi, Junpei</creator><creator>Yokoyama, Yukihiro</creator><creator>Igami, Tsuyoshi</creator><creator>Onoe, Shunsuke</creator><creator>Watanabe, Nobuyuki</creator><creator>Uehara, Kay</creator><creator>Matsuo, Keitaro</creator><creator>Ebata, Tomoki</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6362-2243</orcidid><orcidid>https://orcid.org/0000-0002-8247-7050</orcidid><orcidid>https://orcid.org/0000-0003-2385-5610</orcidid></search><sort><creationdate>202207</creationdate><title>Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma</title><author>Yamada, Mihoko ; Mizuno, Takashi ; Yamaguchi, Junpei ; Yokoyama, Yukihiro ; Igami, Tsuyoshi ; Onoe, Shunsuke ; Watanabe, Nobuyuki ; Uehara, Kay ; Matsuo, Keitaro ; Ebata, Tomoki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3546-3f6f857fd6f0041460f8c8c601009445263937b2172df3022642120a589761753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>AJCC system</topic><topic>Bismuth system</topic><topic>Blumgart system</topic><topic>Cholangiocarcinoma</topic><topic>Classification</topic><topic>perihilar cholangiocarcinoma</topic><topic>tumor staging</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamada, Mihoko</creatorcontrib><creatorcontrib>Mizuno, Takashi</creatorcontrib><creatorcontrib>Yamaguchi, Junpei</creatorcontrib><creatorcontrib>Yokoyama, Yukihiro</creatorcontrib><creatorcontrib>Igami, Tsuyoshi</creatorcontrib><creatorcontrib>Onoe, Shunsuke</creatorcontrib><creatorcontrib>Watanabe, Nobuyuki</creatorcontrib><creatorcontrib>Uehara, Kay</creatorcontrib><creatorcontrib>Matsuo, Keitaro</creatorcontrib><creatorcontrib>Ebata, Tomoki</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamada, Mihoko</au><au>Mizuno, Takashi</au><au>Yamaguchi, Junpei</au><au>Yokoyama, Yukihiro</au><au>Igami, Tsuyoshi</au><au>Onoe, Shunsuke</au><au>Watanabe, Nobuyuki</au><au>Uehara, Kay</au><au>Matsuo, Keitaro</au><au>Ebata, Tomoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><date>2022-07</date><risdate>2022</risdate><volume>29</volume><issue>7</issue><spage>768</spage><epage>777</epage><pages>768-777</pages><issn>1868-6974</issn><eissn>1868-6982</eissn><abstract>Background
Clinical tumor staging is essential information for making a therapeutic decision in cancer. This study aimed to identify the optimal tumor classification system for predicting resectability and survival probability in perihilar cholangiocarcinoma.
Methods
Patients who were treated for perihilar cholangiocarcinoma between 2009 and 2018 were enrolled. Local tumor extension was staged radiologically according to a diameter‐based classification system in addition to the AJCC, Blumgart, and Bismuth systems. Survival and resectability were compared between T subgroups, and the discriminability of the four systems was assessed with Harrell’s concordance index (C‐index).
Results
Among 702 study patients, 559 (80.0%) underwent laparotomy, 489 (70.0%) of whom underwent resection. The resectability significantly decreased for more advanced tumors in all systems (P < .001); the AJCC system had the greatest discriminability for resectability (area under the curve 0.721). Overall survival at 5 years was 69.9% for AJCC cT1, 45.8% for cT2, 31.8% for cT3, and 15.3% for cT4 tumors (cT1 vs cT2; P = .002, cT2 vs cT3; P = .008 and cT3 vs cT4; P < .001). The AJCC system had the largest C‐index of 0.627.
Conclusions
The AJCC T system was the optimal classification system for predicting resectability and survival in perihilar cholangiocarcinoma.
Yamada and colleagues revealed the American Joint Committee on Cancer (AJCC) tumor classification system to be the optimal clinical staging system in perihilar cholangiocarcinoma for predicting resectability and long‐term survival probability. Their findings provide clear evidence to stage local tumor extension using the AJCC system prior to definitive treatment.</abstract><cop>Tokyo</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/jhbp.1066</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-6362-2243</orcidid><orcidid>https://orcid.org/0000-0002-8247-7050</orcidid><orcidid>https://orcid.org/0000-0003-2385-5610</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | AJCC system Bismuth system Blumgart system Cholangiocarcinoma Classification perihilar cholangiocarcinoma tumor staging Tumors |
| title | Superiority of clinical American Joint Committee on Cancer T classification for perihilar cholangiocarcinoma |
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