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Analysis of the seventh edition of American Joint Committee on colon cancer staging

  • Yuan-Tzu Lan
  • Shung-Haur Yang
  • Shih-Ching Chang
  • Wen-Yih Liang
  • Anna Fen-Yau Li
  • Huann-Sheng Wang
  • Jeng-Kai Jiang
  • Wei-Shone Chen
  • Tzu-Chen Lin
  • Jen-Kou LinEmail author
Original Article

Abstract

Purpose

The seventh edition of the American Joint Committee on Cancer (AJCC) staging system has new substages for colon cancer. We used survival data from a single medical center to analyze this new AJCC edition.

Methods

The colon cancer database of Taipei Veterans General Hospital provided 1,865 patient records covering from 1999 to 2005. Survival rates were evaluated using the Kaplan–Meier method.

Results

There were 268, 607, 561, and 421 patients in stages I, II, III, and IV disease with 5-year observed survival rates of 86.3%, 79.2%, 65.4%, and 12.8%, respectively. Survival rates were not significantly different between those with T4a and T4b disease (P = 0.806). The outcome of N1c disease was similar to N1a and N1b but worse than N0 (P = 0.004). Survival rates for M1a and M1b disease became different after reclassifying solely peritoneal seeding as M1a (P < 0.001). No discrepancy of outcomes between stage IIIA and stage IIB/IIC remained in the seventh edition.

Conclusions

Evolution from the fifth to seventh edition of the AJCC staging system is successful in separating prognostic groups by substaging. But some issues remain unresolved, including the subdivision of T4, N1, and M1.

Keywords

Colonic neoplasms Survival Neoplasm staging 

Notes

Acknowledgments

This study received the grant support from the Department of Health Center of Excellence for Cancer Research at the Taipei Veterans General Hospital (DOH99-TD-C-111-007), the research grants from National Science Council NSC-(100-2314-B-075-062-), and Department of Medical Research and Education, Taipei Veterans General Hospital (V100B-011).

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Yuan-Tzu Lan
    • 1
    • 2
    • 3
  • Shung-Haur Yang
    • 1
    • 2
  • Shih-Ching Chang
    • 1
    • 2
  • Wen-Yih Liang
    • 4
  • Anna Fen-Yau Li
    • 4
  • Huann-Sheng Wang
    • 1
  • Jeng-Kai Jiang
    • 1
    • 2
  • Wei-Shone Chen
    • 1
    • 2
  • Tzu-Chen Lin
    • 1
  • Jen-Kou Lin
    • 1
    • 2
    Email author
  1. 1.Division of Colon and Rectal Surgery, Department of SurgeryTaipei Veterans General HospitalTaipei CityRepublic of China
  2. 2.Department of SurgeryNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan
  4. 4.Division of Surgical Pathology, Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan

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