Prognostic Impact of Tumor Growth Type on 7th AJCC Staging System for XXXX : a Single-Center Experience of 659 Cases.

@entity5 @entity1 @entity1419 @entity3
OBJECTIVE: Because noticeable changes were made to the 7th American Joint Committee on Cancer (AJCC) @entity5 -node- @entity3 (TNM) staging for @entity1419 ( @entity1419 ), we validated the prognostic impact of @entity5 staging after macroscopic curative resection of @entity1419 . METHODS: A cohort of 659 @entity1419 @entity1 who underwent R0 (n   =   539) or R1 (n   =   120) resection were selected with exclusion of R2 resection (n   =   111). Study @entity1 were followed up for >= 24  months or until death with no @entity1 lost during survival analysis. RESULTS: Anatomical resection was performed in 599 (90.9  %) and concurrent bile duct resection was conducted in 97 (14.7  %). Median survival periods following R0, R1, and R2 resections were 28, 12, and 3  months, respectively (p   =   0.000). In the R0 resection group, the 1-, 3-, 5-, and 10-year @entity5 recurrence rates were 36.4  %, 57.9  %, 64.7  %, and 65.0  %, respectively, and the 1-, 3-, 5-, and 10-year @entity1 survival rates were 73.1  %, 44.2  %, 33.0  %, and 23.1  %, respectively. Independent risk factors for @entity5 recurrence and @entity1 survival were @entity5 growth type, @entity5 size   >   5  cm, perineural invasion, and lymph node @entity3 . According to the 7th AJCC staging system, the prognostic contrast was marginal in stage T2-4 @entity5 without lymph node @entity3 (p   >   0.8). With our redefined staging system with @entity5 growth types and risk factors including @entity5 number and @entity3 , clear prognostic contrast was achieved among T1-3 stages (p   =   0.000). CONCLUSION: Growth type of @entity1419 seems to be essential for determining @entity5 stage. Although the stratification of the 7th AJCC @entity1419 staging system seems reasonably established, refinements and further validation could improve prognostic predictability.
