Mesenterico-portal vein invasion should be an important factor in TNM staging for pancreatic ductal adenocarcinoma: Proposed modification of the 8th edition of the American Joint Committee on Cancer staging system

doi:10.3748/wjg.v25.i46.6752

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World J Gastroenterol. Dec 14, 2019; 25(46): 6752-6766
Published online Dec 14, 2019. doi: 10.3748/wjg.v25.i46.6752

Table 5 Verification of the modified staging system in predicting prognosis

Stage	SEER database				West China Hospital database
Stage	Median survival	1-yr survival rate, % (±%)	3-yr survival rate, % (±%)	5-yr survival rate, % (±%)	Median survival	1-yr survival rate, % (±%)	3-yr survival rate, % (±%)	5-yr survival rate, % (±%)
Prognostic comparison of different 8^th edition AJCC T classifications
AJCC T1	27 (± 1.1)	78.7 (± 1.2)	39.7 (± 1.5)	27.0 (± 1.5)	25 (± 2.2)	82.6 (± 3.3)	32.9 (± 4.8)	24.4 (± 4.9)
AJCC T2	20 (± 0.3)	68.9 (± 0.7)	26.0 (± 0.7)	16.1 (± 0.7)	19 (± 0.9)	72.0 (± 2.2)	21.5 (± 2.4)	11.4 (± 2.2)
AJCC T3	15 (± 0.5)	61.7 (± 1.4)	18.7 (± 1.2)	9.9 (± 1.0)	15 (± 1.6)	53.5 (± 5.3)	10.4 (± 4.1)	3.1 (± 2.8)
T1 vs T2	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.002^a	P = 0.008^a	P = 0.034^a	P = 0.016^a
T2 vs T3	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.001^a	P = 0.019^a	P = 0.020^a
Prognostic comparison of different modified T classifications
Modified T1	28 (± 1.2)	78.7 (± 1.2)	41.1 (± 1.6)	27.8 (± 1.6)	26 (± 2.6)	82.6 (± 3.4)	35.7 (± 5.1)	26.5 (± 5.2)
Modified T2	20 (± 0.4)	69.2 (± 0.7)	26.6 (± 0.8)	16.4 (± 0.7)	21 (± 1.1)	72.8 (± 2.4)	21.8 (± 2.8)	13.8 (± 2.7)
Modified T3	16 (± 0.4)	60.5 (± 1.2)	19.1 (± 1.0)	10.7 (± 0.9)	15 (± 0.8)	61.1 (± 3.7)	7.7 (± 2.5)	2.6 (± 1.6)
T1 vs T2	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.004^a	P = 0.019^a	P = 0.017^a	P = 0.030^a
T2 vs T3	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.008^a	P = 0.000^a	P = 0.000^a
Prognostic comparison of different 8^th edition AJCC stages
AJCC IA	38 (± 3.4)	84.8 (± 1.6)	50.7 (± 2.5)	38.9 (± 2.6)	30 (± 4.6)	84.9 (± 3.9)	43.9 (± 6.5)	34.8 (± 7.0)
AJCC IB	27 (± 1.1)	77.8 (± 1.2)	39.4 (± 1.5)	27.2 (± 1.5)	23 (± 1.8)	78.2 (± 2.7)	25.6 (± 3.6)	18.3 (± 3.5)
AJCC IIA	20 (± 1.0)	70.0 (± 2.8)	25.8 (± 2.9)	14.1 (± 2.6)	16 (± 2.0)	58.4 (± 7.6)	9.9 (± 6.3)	5.0 (± 4.7)
AJCC IIB	19 (± 0.4)	68.2 (± 0.9)	25.2 (± 0.9)	15.3 (± 0.8)	17 (± 0.9)	66.1 (± 3.1)	12.7 (± 2.6)	4.5 (± 2.3)
AJCC III	16 (± 0.4)	59.4 (± 1.1)	16.8 (± 0.9)	7.9 (± 0.7)	15 (± 2.7)	53.3 (± 7.2)	6.8 (± 4.3)	0.0
IA vs IB	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.014^a	P = 0.158	P = 0.014^a	P = 0.035^a
IB vs IIA	P = 0.000^a	P = 0.010^a	P = 0.000^a	P = 0.000^a	P = 0.001^a	P = 0.014^a	P = 0.030^a	P =0.023^a
IIA vs IIB	P = 0.958	P = 0.541	P = 0.843	P = 0.659	P = 0.425	P = 0.348	P = 0.681	P = 0.924
IIB vs III	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.000^a	P = 0.018^a	P = 0.102	P = 0.240	P = 0.050
Prognostic comparison of different modified stages
Modified IA	38 (± 3.6)	84.7 (± 1.7)	51.7 (± 2.5)	39.4 (± 2.7)	32 (± 5.3)	84.2 (± 4.0)	45.4 (± 6.6)	36.0 (± 7.1)
Modified IB	27 (± 1.3)	80.7 (± 1.2)	40.1 (± 1.6)	27.6 (± 1.6)	24 (± 1.6)	79.0 (± 2.9)	28.6 (± 4.0)	20.9 (± 4.0)
Modified IIA	25 (± 1.4)	75.6 (± 2.0)	36.3 (± 2.3)	22.5 (± 2.2)	21 (± 3.3)	77.3 (± 7.1)	22.1 (± 7.6)	14.7 (± 6.6)
Modified IIB	20 (± 0.5)	69.7 (± 1.0)	25.4 (± 1.0)	15.7 (± 0.9)	18 (± 1.1)	67.1 (± 3.4)	10.5 (± 2.8)	4.1 (± 2.2)
Modified III	16 (± 0.3)	60.0 (± 0.9)	17.4 (± 0.8)	8.6 (± 0.7)	15 (± 1.0)	56.2 (± 4.5)	7.8 (± 2.8)	0.0 (± 0.0)
IA vs IB	P = 0.000^a	P = 0.055	P = 0.000^a	P = 0.000^a	P = 0.044^a	P = 0.293	P = 0.029^a	P = 0.064
IB vs IIA	P = 0.008^a	P = 0.029^a	P = 0.175	P = 0.061	P = 0.425	P = 0.825	P = 0.449	P = 0.422
IIA vs IIB	P = 0.000^a	P = 0.008^a	P = 0.000^a	P = 0.004^a	P = 0.043^a	P = 0.195	P = 0.152	P = 0.128
IIB vs III	P = 0.000^a	P =0.000^a	P = 0.000^a	P = 0.000^a	P = 0.004^a	P = 0.053	P = 0.495	P = 0.062

Values in parentheses are the standard error of median survival or standard error of survival rate.

^aP < 0.05. SEER: Surveillance, epidemiology, and end results; AJCC: American Joint Committee on Cancer.

Citation: Chen HY, Wang X, Zhang H, Liu XB, Tan CL. Mesenterico-portal vein invasion should be an important factor in TNM staging for pancreatic ductal adenocarcinoma: Proposed modification of the 8^th edition of the American Joint Committee on Cancer staging system. World J Gastroenterol 2019; 25(46): 6752-6766
URL: https://www.wjgnet.com/1007-9327/full/v25/i46/6752.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i46.6752