TY - JOUR
T1 - Evidence-based gallbladder cancer staging
T2 - Changing cancer staging by analysis of data from the national cancer database
AU - Fong, Yuman
AU - Wagman, Lawrence
AU - Gonen, Mithat
AU - Crawford, James
AU - Reed, William
AU - Swanson, Richard
AU - Pan, Charlie
AU - Ritchey, Jamie
AU - Stewart, Andrew
AU - Choti, Michael
PY - 2006/6
Y1 - 2006/6
N2 - BACKGROUND: A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stage IVA to stage III. METHODS: In order to determine if these changes were justified by data, an analysis of the 10,705 cases of gallbladder cancer collected between 1989 and 1996 in the NCDB was performed. All patients had >5 year follow-up. RESULTS: The staging according to the 6th Edition provided no discrimination between stage III and IV. Five-year survivals for stage IIA, IIB, III, and IV (6th Edition) were 7%, 9%, 3%, 2% respectively. The data from the National Cancer Database (NCDB) were used to derive a proposed new staging system that builds upon Edition 5 and had improved discrimination of stage groups over previous editions. CONCLUSIONS: Changes in staging systems should be justified by data. Multicenter databases, including the NCDB, represent important resources for verification of evidence-based staging systems.
AB - BACKGROUND: A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stage IVA to stage III. METHODS: In order to determine if these changes were justified by data, an analysis of the 10,705 cases of gallbladder cancer collected between 1989 and 1996 in the NCDB was performed. All patients had >5 year follow-up. RESULTS: The staging according to the 6th Edition provided no discrimination between stage III and IV. Five-year survivals for stage IIA, IIB, III, and IV (6th Edition) were 7%, 9%, 3%, 2% respectively. The data from the National Cancer Database (NCDB) were used to derive a proposed new staging system that builds upon Edition 5 and had improved discrimination of stage groups over previous editions. CONCLUSIONS: Changes in staging systems should be justified by data. Multicenter databases, including the NCDB, represent important resources for verification of evidence-based staging systems.
UR - http://www.scopus.com/inward/record.url?scp=33745299311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745299311&partnerID=8YFLogxK
U2 - 10.1097/01.sla.0000219737.81943.4e
DO - 10.1097/01.sla.0000219737.81943.4e
M3 - Article
C2 - 16772780
SN - 0003-4932
VL - 243
SP - 767
EP - 771
JO - Annals of Surgery
JF - Annals of Surgery
IS - 6
ER -