Validation of the 8th Edition of the American Joint Committee onCancer Staging System for Gallbladder Cancer and Implications forthe Follow-up of Patients without Node Dissection
- Author:
You-Na SUNG
1
;
Minjeong SONG
;
Jae Hoon LEE
;
Ki Byung SONG
;
Dae Wook HWANG
;
Chul-Soo AHN
;
Shin HWANG
;
Seung-Mo HONG
Author Information
- Publication Type:Original Article
- From:Cancer Research and Treatment 2020;52(2):455-468
- CountryRepublic of Korea
- Language:0
-
Abstract:
Purpose:The 8th edition of gallbladder cancer staging in the American Joint Committee on Cancer(AJCC) staging system changed the T and N categories.
Materials and Methods:In order to validate the new staging system, a total of 348 surgically resected gallbladdercancers were grouped based on the 8th edition of the T and N categories and comparedwith patients’ survival.
Results:Significant differences were noted between T1b-T2a (p=0.003) and T2b-T3 (p < 0.001)tumors, but not between Tis-T1a, T1a-T1b, and T2a-T2b tumors. However, significant survivaldifferences were observed both by the overall and pair-wise (T1-T2, T2-T3) comparisons(all, p < 0.001) without dividing T1/T2 subcategories. When cases with ! 6 examined lymphnodes were evaluated, significant survival differences were observed among the entire comparison(p < 0.001) and pair-wise comparisons of N0-N1 (p=0.001) and N1-N2 (p=0.039)lesions. When cases without nodal dissection (NX) were additionally compared, significantsurvival differences were observed between patients with N0-NX (p=0.001) and NX-N1(p < 0.001) lesions.
Conclusion:The T category in the 8th edition of the AJCC staging system did not completely stratify theprognosis of patients with gallbladder cancer. Modification by eliminating T subcategoriescan better stratify the prognosis. In contrast, the N category clearly determines patients’survival with ! 6 examined lymph nodes. The survival time in patients of gallbladder cancerswithout nodal dissection is between N0 and N1 cases. Therefore, close postoperative followedup is recommended for those patients.
