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Daniel G. Coit - One of the best experts on this subject based on the ideXlab platform.

  • Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association Staging project
    Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2016
    Co-Authors: Takeshi Sano, Daniel G. Coit, Hyung-ho Kim, Franco Roviello, Paulo Kassab, Christian Wittekind, Yuko Yamamoto, Yasuo Ohashi
    Abstract:

    Background The current AJCC Staging System for gastric cancer (AJCC7) incorporated several major revisions to the previous edition. The T and N categories and the stage groups were newly defined, and adenocarcinoma of the esophagogastric junction (EGJ) was reclassified and staged according to the esophageal System. Studies to validate these changes showed inconsistent results. The International Gastric Cancer Association (IGCA) launched a project to support evidence-based revisions to the next edition of the AJCC Staging System.

  • A single-institution validation of the AJCC Staging System for stage IV melanoma.
    Annals of surgical oncology, 2008
    Co-Authors: Heather B. Neuman, Ami Patel, Nicole Ishill, Christine Hanlon, Mary Sue Brady, Allan C. Halpern, Alan N. Houghton, Daniel G. Coit
    Abstract:

    Background Survival of patients with stage IV melanoma is poor. In the current American Joint Committee on Cancer (AJCC) Staging System, site of distant disease and lactate dehydrogenase (LDH) are the only prognostic factors included for stage IV disease. We sought to validate the current AJCC Staging System in a contemporary, prospectively collected cohort of patients and explore additional factors that may influence prognosis.

  • A single-institution validation of the AJCC Staging System for stage IV melanoma
    Journal of Clinical Oncology, 2007
    Co-Authors: Heather B. Neuman, Ami Patel, Christine Hanlon, Mary Sue Brady, Allan C. Halpern, Alan N. Houghton, Daniel G. Coit
    Abstract:

    8517 Background: We sought to validate the AJCC Staging System for stage IV melanoma in a contemporary, prospective, single- institution cohort and explore additional clinical factors that may infl...

  • Estimating survival probability in stage III melanoma: A multivariable individualized patient risk assessment nomogram
    Journal of Clinical Oncology, 2006
    Co-Authors: Daniel G. Coit, Ami Patel, C. Qin Zhou, K. S. Panageas
    Abstract:

    8020 Background: Recent revisions in the AJCC Staging System have increased its complexity without comparable improvement in prognostic accuracy for patients with Stage III melanoma. Furthermore, t...

  • A Nomogram That Predicts the Presence of Sentinel Node Metastasis in Melanoma With Better Discrimination Than the American Joint Committee on CancerStaging System
    Annals of Surgical Oncology, 2005
    Co-Authors: Sandra L. Wong, Michael W. Kattan, Kelly M. Mcmasters, Daniel G. Coit
    Abstract:

    Background The threshold and indications for sentinel lymph node (SLN) biopsy in patients with melanoma remain somewhat arbitrary. Many variables associated with SLN positivity have previously been identified, including a significant association between the American Joint Committee on Cancer (AJCC) Staging System and SLN status. We developed a user-friendly nomogram that takes several characteristics into account simultaneously to more accurately predict the presence of SLN metastasis for an individual patient. Methods A total of 979 patients who underwent successful SLN biopsy for cutaneous melanoma at a single institution between February 1991 and November 2003 were included in the analysis. Predictors were used to develop a nomogram, based on logistic regression analysis, to predict the probability of SLN positivity. A large multi-institutional trial with 3108 patients was used to validate the predictive accuracy of the nomogram compared with the AJCC Staging System. Results The nomogram was developed and found to be accurate and discriminating. The concordance index of the nomogram, a measure of predictive ability, was .694 when evaluated with the validation dataset. In contrast, the concordance index of the AJCC Staging System was lower (.663; P < .001). Conclusions Using commonly available clinicopathologic information, we developed a nomogram to accurately predict the probability of a positive SLN in patients with melanoma. This tool takes several characteristics into account simultaneously. This model should enable improved patient counseling and treatment selection.

Omar Abdel-rahman - One of the best experts on this subject based on the ideXlab platform.

  • Assessment of the external validity of the American Joint Committee on Cancer 8th Staging System for anal carcinoma.
    Current medical research and opinion, 2018
    Co-Authors: Hani Oweira, Anwar Giryes, Meinrad Mannhart, Michael Decker, Rolf Schlumpf, Omar Abdel-rahman
    Abstract:

    Background: The current study evaluates the prognostic value of the 8th edition of the American Joint Committee on Cancer (AJCC) Staging System for patients with anal carcinoma.Patients and methods...

  • Revisiting the Prognostic Heterogeneity of AJCC Stage IV Carcinomas of the Upper Urinary Tract.
    Clinical genitourinary cancer, 2018
    Co-Authors: Omar Abdel-rahman
    Abstract:

    Abstract Background Current Staging paradigms from the American Joint Committee on Cancer (AJCC) Staging System for upper urinary tract carcinomas treat locoregionally advanced (T4 and N+) and metastatic (M1) patients as a single entity (stage IV). The current study proposes a modification of the AJCC Staging System where these 2 entities are separated. Methods The Surveillance, Epidemiology, and End Results (SEER) database (2004-2014) was accessed through SEER*Stat program. Overall survival (OS) analyses according to AJCC and modified Staging Systems were conducted through Kaplan-Meier analysis. Moreover, cancer-specific survival analysis was conducted through a Cox proportional hazard model. Results OS was compared according to AJCC and modified AJCC Staging Systems. The P value for OS trend for both Staging Systems was  Conclusion Dividing stage IV upper urinary tract carcinomas into locoregionally advanced and metastatic disease subcategories improves the prognostic utility of the Staging System compared to the current AJCC Staging System. Given the limitations of a SEER-based study, this concept needs to be externally validated in various settings.

  • Evaluation of the 8th AJCC Staging System for pathologically versus clinically staged pancreatic adenocarcinoma: A time to revisit a dogma?
    Hepatobiliary & pancreatic diseases international : HBPD INT, 2018
    Co-Authors: Omar Abdel-rahman
    Abstract:

    Abstract Background The 8th edition of the American Joint Committee on Cancer (AJCC) Staging System for pancreatic exocrine adenocarcinoma has been released. The current study seeks to assess the 7th and 8th editions among patients registered within the surveillance, epidemiology and end results (SEER) database. Methods SEER database (2010–2013) has been accessed through SEER*Stat program and AJCC 8th edition stages were reconstructed utilizing the collaborative stage descriptions. Kaplan–Meier analysis of overall survival and pancreatic cancer-specific survival analyses (according to both 7th and 8th editions and according to whether pathological or clinical Staging were conducted) has been performed. Multivariate analysis of factors affecting pancreatic cancer-specific survival was also conducted through a Cox proportional hazard model. Results A total of 18  948 patients with pancreatic adenocarcinoma were identified in the period from 2010–2013. Pancreatic cancer-specific survival among pathologically staged patients and according to the 8th edition showed significant differences for all pair wise comparisons among different stages (P  Conclusion There is clearly a need to have two Staging Systems for pancreatic adenocarcinoma: pathological and clinical Staging Systems.

  • Validation of the 8th AJCC Staging System for gastric cancer in a population-based setting.
    Expert review of gastroenterology & hepatology, 2017
    Co-Authors: Omar Abdel-rahman
    Abstract:

    ABSTRACTBackground: The aim of this analysis is to validate the prognostic value of the 8th edition of the American Joint Committee on Cancer (AJCC) Staging System for gastric cancer.Methods: Through SEER*Stat program, Surveillance, epidemiology and end results database (2010–2013) was accessed and 8th AJCC stages were reconstructed. Cancer-specific survival analyses according to both 7th and 8th editions were conducted through Kaplan-Meier analysis/log-rank testing and multivariate analysis was conducted through a Cox model.Results: Among pathologically-staged patients, P values for pairwise comparisons among different 8th AJCC stages were significant (

  • Assessment of the prognostic value of the 8th AJCC Staging System for patients with clinically staged prostate cancer; A time to sub-classify stage IV?
    PloS one, 2017
    Co-Authors: Omar Abdel-rahman
    Abstract:

    BACKGROUND The American Joint Committee on Cancer (AJCC) Staging System (8th edition) for prostate cancer has been published. The current study seeks to validate the prognostic performance of the changes in the new System among clinically staged prostate cancer patients registered within the surveillance, epidemiology and end results (SEER) database. METHODS SEER database (2004-2014) has been accessed through SEER*Stat program and AJCC 7th and 8th edition stages were calculated utilizing T, N and M stages as well as baseline prostatic specific antigen (PSA) and grade group. Cancer-specific and overall survival analyses according to 6th, 7th and 8th editions were conducted through Kaplan-Meier analysis. Moreover, multivariate analysis was conducted through a Cox proportional hazard model. RESULTS A total of 110499 patients with prostate cancer were identified in the period from 2004-2014.For cancer- specific survival according to 8th AJCC, all pair wise P values for comparison were significant (

Heather B. Neuman - One of the best experts on this subject based on the ideXlab platform.

Ami Patel - One of the best experts on this subject based on the ideXlab platform.

Ying Sun - One of the best experts on this subject based on the ideXlab platform.

  • Validation of the 8th Edition of the UICC/AJCC Staging System for Nasopharyngeal Carcinoma From Endemic Areas in the Intensity-Modulated Radiotherapy Era
    Journal of the National Comprehensive Cancer Network : JNCCN, 2017
    Co-Authors: Ling Long Tang, Li Tian, Yu Pei Chen, Yan Ping Mao, Zi Xian Wang, Rui Guo, Lei Chen, Ai Hua Lin, Ying Sun
    Abstract:

    Background: In this study, we evaluated the 8th edition of the Union for International Cancer Control (UICC)/AJCC Staging System for nasopharyngeal carcinoma (NPC) in an endemic area, with the aim of validating its applicability and providing further information for future refinements. Methods: A total of 1,790 patients with newly diagnosed, non-distant metastatic, histologically proven NPC treated with intensity-modulated radiotherapy (IMRT) were retrospectively reviewed. The performance of various Staging Systems was compared using the Akaike information criterion (AIC) and Harrell's concordance index (c-index). Results: For N (node) category, the survival curves of different groups according to the 8th edition were well-separated, and the prognostic model predicted outcomes fairly well. The 8th edition had higher AIC and c-index values for all end points than the 7th edition. However, probably due to the improved locoregional control provided by IMRT, the survival curves for T2 and T3 almost overlapped, without significant differences in locoregional failure-free survival (P=.606) and disease-free survival (P=.735). Due to the difficultly of differentiating T2 and T3, the AIC and c-index values were similar for the T categories of the 7th and 8th editions. Similarly, the overall survival and disease-free survival curves for stage II and III disease were not clearly separated for either the 8th or 7th editions. Conclusions: The 8th edition of the UICC/AJCC Staging System for NPC enables more accurate prediction of treatment outcomes. However, several limitations need to be addressed in future editions, and it would be reasonable to further optimize the T category classification.

  • validation of the 8th edition of the uicc AJCC Staging System for nasopharyngeal carcinoma from endemic areas in the intensity modulated radiotherapy era
    Journal of The National Comprehensive Cancer Network, 2017
    Co-Authors: Ling Long Tang, Li Tian, Yu Pei Chen, Yan Ping Mao, Zi Xian Wang, Rui Guo, Lei Chen, Ai Hua Lin, Ying Sun
    Abstract:

    Background: In this study, we evaluated the 8th edition of the Union for International Cancer Control (UICC)/AJCC Staging System for nasopharyngeal carcinoma (NPC) in an endemic area, with the aim of validating its applicability and providing further information for future refinements. Methods: A total of 1,790 patients with newly diagnosed, non-distant metastatic, histologically proven NPC treated with intensity-modulated radiotherapy (IMRT) were retrospectively reviewed. The performance of various Staging Systems was compared using the Akaike information criterion (AIC) and Harrell's concordance index (c-index). Results: For N (node) category, the survival curves of different groups according to the 8th edition were well-separated, and the prognostic model predicted outcomes fairly well. The 8th edition had higher AIC and c-index values for all end points than the 7th edition. However, probably due to the improved locoregional control provided by IMRT, the survival curves for T2 and T3 almost overlapped, without significant differences in locoregional failure-free survival (P=.606) and disease-free survival (P=.735). Due to the difficultly of differentiating T2 and T3, the AIC and c-index values were similar for the T categories of the 7th and 8th editions. Similarly, the overall survival and disease-free survival curves for stage II and III disease were not clearly separated for either the 8th or 7th editions. Conclusions: The 8th edition of the UICC/AJCC Staging System for NPC enables more accurate prediction of treatment outcomes. However, several limitations need to be addressed in future editions, and it would be reasonable to further optimize the T category classification.

  • the seventh edition of the uicc AJCC Staging System for nasopharyngeal carcinoma is prognostically useful for patients treated with intensity modulated radiotherapy from an endemic area in china
    Radiotherapy and Oncology, 2012
    Co-Authors: Lei Chen, Li Tian, Li Zhi Liu, Ling Long Tang, Yan Ping Mao, Ying Sun, Fang Yun Xie, Ai Hua Lin
    Abstract:

    Abstract Purpose To evaluate the 7th edition of the International Union against Cancer/American Joint Committee on Cancer (UICC/AJCC) Staging System for nasopharyngeal carcinoma (NPC) in patients treated with intensity-modulated radiotherapy. Methods and materials We performed a retrospective data review from 512 patients with biopsy-proven, nonmetastatic NPC in our cancer center (South China) between January 2003 and December 2006. Results The local relapse-free survival rates (LRFS) and disease failure-free survival rates (DFS) in the 6th edition System T1 and T2a stages were not significantly different (P = 0.629 and P = 0.820), while the LRFS and DFS of T1 and T2 using the 7th edition System were significantly different (P = 0.019 and P = 0.009). The LRFS and DFS between T2 and T3 in the 7th edition Systems were lack of significance (P = 0.874 and P = 0.589). The total difference in distant metastasis-free survival rate and DFS between N0 and N3 was slightly larger using the 7th edition System than the 6th edition. The nodal dimension of a cervical lymph node was not a significant prognostic factor. Conclusions We observed a better segregation of survival curves by using the 7th edition System. It seems reasonable to downstage T3 as T2 and reject nodal greatest dimension from the N-Staging System in the future revised edition.

  • Promising treatment outcomes of intensity-modulated radiation therapy for nasopharyngeal carcinoma patients with N0 disease according to the seventh edition of the AJCC Staging System.
    BMC cancer, 2012
    Co-Authors: Ying Sun, Li Zhi Liu, Ling Long Tang, Yan Ping Mao, Lei Chen, Ai Hua Lin
    Abstract:

    Intensity-modulated radiation therapy (IMRT) provides excellent locoregional control for nasopharyngeal carcinoma (NPC), and has gradually replaced two-dimensional conventional radiotherapy as the first-line radiotherapy technique. Furthermore, in the new seventh edition of the American Joint Committee on Cancer (AJCC) Staging System, retropharyngeal lymph nodes were upgraded from N0 to N1 disease as a result of their negative impact on the distant metastasis-free survival (DMFS) rates of NPC. This retrospective study was conducted in order to review the treatment outcomes and patterns of failure in NPC patients with N0 disease after IMRT in order to effectively guide treatment in the future. We retrospectively reviewed data from 506 biopsy-proven nonmetastatic NPC patients. There were 191 patients with negative cervical lymph node involvement. According to the seventh edition of the American Joint Committee on Cancer (AJCC) Staging System, 110 patients (21.7%) were staged with N0 disease, and 81 patients (16.0%) were reclassified with N1 disease due to the presence of RLN metastasis. All patients received IMRT as the primary treatment. In patients with negative cervical lymph node involvement, distant metastasis-free survival (DMFS) was significantly higher in patients without retropharyngeal lymph node (RLN) metastasis than those with RLN metastasis (95.9% vs. 88.1% respectively, P = 0.04). For N0 disease, the 5-year overall survival (OS), local relapse-free survival (LRFS), nodal relapse-free survival (NRFS) and DMFS rates were 93.8%, 97.1%, 99.1% and 95.9%, respectively. For T1N0, T2N0, T3N0 and T4N0, OS was 97.8%, 100%, 93.8% and 76.9%, LRFS was 100%, 92.9%, 100% and 88.9% and DMFS was 96.6%, 90.9%, 100% and 93.3%, respectively. OS and LRFS were higher in T1-3 N0 patients than T4N0 patients (P < 0.01 and P = 0.01, respectively). The seventh edition of the AJCC N-Staging System improves prognostic accuracy by upgrading RLN metastasis to N1 disease. IMRT produces excellent survival rates in T1-3 N0 disease; however, T4N0 disease remains a challenge and additional improvements are required to achieve a favorable prognosis for these NPC patients.

  • The seventh edition of the UICC/AJCC Staging System for nasopharyngeal carcinoma is prognostically useful for patients treated with intensity-modulated radiotherapy from an endemic area in China.
    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2011
    Co-Authors: Lei Chen, Li Tian, Li Zhi Liu, Ling Long Tang, Yan Ping Mao, Ying Sun, Fang Yun Xie, Ai Hua Lin
    Abstract:

    Abstract Purpose To evaluate the 7th edition of the International Union against Cancer/American Joint Committee on Cancer (UICC/AJCC) Staging System for nasopharyngeal carcinoma (NPC) in patients treated with intensity-modulated radiotherapy. Methods and materials We performed a retrospective data review from 512 patients with biopsy-proven, nonmetastatic NPC in our cancer center (South China) between January 2003 and December 2006. Results The local relapse-free survival rates (LRFS) and disease failure-free survival rates (DFS) in the 6th edition System T1 and T2a stages were not significantly different (P = 0.629 and P = 0.820), while the LRFS and DFS of T1 and T2 using the 7th edition System were significantly different (P = 0.019 and P = 0.009). The LRFS and DFS between T2 and T3 in the 7th edition Systems were lack of significance (P = 0.874 and P = 0.589). The total difference in distant metastasis-free survival rate and DFS between N0 and N3 was slightly larger using the 7th edition System than the 6th edition. The nodal dimension of a cervical lymph node was not a significant prognostic factor. Conclusions We observed a better segregation of survival curves by using the 7th edition System. It seems reasonable to downstage T3 as T2 and reject nodal greatest dimension from the N-Staging System in the future revised edition.