Independent validation of the 2010 American Joint Committee on Cancer @entity2802 classification for XXXX : results from a large, single institution cohort.

@entity1 @entity5 @entity2802 @entity3121 @entity1358
PURPOSE: In 2010 the American Joint Committee on Cancer updated the @entity1358 @entity2802 classification. Without independent validation of the new classification its predictive ability for @entity5 specific survival and generalizability remains unknown. In this setting we determined the predictive ability of the 2010 @entity2802 classification compared to that of the 2002 classification. MATERIALS AND METHODS: Using the nephrectomy registry at our institution we retrospectively reviewed the records of 3,996 @entity1 with unilateral or bilateral @entity1358 treated with radical nephrectomy or nephron sparing surgery between 1970 and 2006. Cancer specific survival was estimated using the Kaplan-Meier method and predictive ability was evaluated using the concordance index. RESULTS: There were 1,165 deaths (29.1%) from @entity1358 a median of 1.9 years after surgery compared to a median followup of 7.4 years for survivors. The estimated 10-year @entity5 specific survival rate was 96%, 80%, 66%, 55%, 36%, 26%, 25% and 12% for @entity1 with 2010 @entity5 classifications of pT1a, pT1b, pT2a, pT2b, pT3a, pT3b, pT3c and pT4, respectively (p <0.001). The multivariate concordance index for the 2002 and 2010 @entity2802 classifications was 0.848 and 0.850, respectively. CONCLUSIONS: The new 2010 classification remains a robust predictor of @entity5 specific survival compared to the 2002 classification by dividing pT2 lesions into pT2a and pT2b, reclassifying ipsilateral adrenal involvement as pT4, reclassifying renal vein involvement as pT3a and simplifying nodal involvement as pN0 vs @entity3121 . However, the 2010 @entity2802 classification showed only modest improvement in predictive ability compared to the 2002 classification.
