Is the prediction of prognosis not improved by the seventh edition of the TNM classification for colorectal cancer? Analysis of the surveilla006Ece, epidemiology, and end results (SEER) database

Abstract

BackgroundWhether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable. We aimed to compare the predictive capacity of the AJCC-7 for colorectal cancer with the 6th edition of the AJCC TNM staging system (AJCC-6).MethodsThe National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) dataset consisting of 158,483 records was used in this study. We evaluated the predictive capacity of the two editions of the staging system using Harrell’s C index and Bayesian Information Criterion (BIC).ResultsThere was a significant prognostic difference between patients at stage IIB and IIC (P < 0.001). Stage III patients with similar prognoses were adequately sub-grouped in the same stage according to AJCC-7. The Harrell’s C index revealed a value of 0.7692 for AJCC-7, which was significantly better than 0.7663 for AJCC-6 (P < 0.001). BIC analysis provided consistent results (P < 0.001).ConclusionsThis study demonstrates that AJCC-7 is superior to the AJCC-6 staging system in predictive capacity.

TMPRSS4 correlates with colorectal cancer pathological stage and regulates cell proliferation and self-renewal ability

“…HT-29 and HCT116 were cultured in McCoy's 5A medium (10-050-CV, Corning) with 10% fetal bovine serum (FBS) (35-076-CV, Corning); SW480, SW620, and SW1116 were cultured in L-15 medium (GNM41300, Genom) containing 10% FBS; Caco-2 and LoVo were cultured in RPMI 1640 (10-043-CV, Corning) containing 10% FBS and F-12K containing 10% FBS (GNM21127, Genom), respectively. Cells were placed in a humiliated incubator at 37 °C with 5% CO 2 .…”

“…1 Although the 5-y survival rate for early stage CRCs is fairly high, the prognosis of late stage CRCs, i.e., high risk stage II, stage III, and stage IV, remains to be improved. 2 Of note, the major cause of CRC related deaths is metastases to distant organs, such as liver and lung. 3 Despite efforts in investigating comprehensive therapy including surgery, chemotherapy, and radiotherapy for CRCs, molecular targets which play crucial roles in the tumorigenesis and metastasis of CRCs need to be explored.…”

The tumour–stroma ratio in colon cancer: the biological role and its prognostic impact

“…For instance, 5–25% of stage II patients still develop recurrence of disease within 5 years. In addition, patients with stage IIB have a worse prognosis than stage IIIA colon cancer patients, leading in some cases to undertreatment of stage II patients and overtreatment of stage III patients …”

Over-expression of AURKA, SKA3 and DSN1 contributes to colorectal adenoma to carcinoma progression

“…Five-year survival rates for early-stage CRC patients (TNM stages I-II) range from 70-90%, but drop dramatically to 10-60% for advanced-stage patients (TNM stages III-IV) [2, 3], demonstrating the importance of early detection. Multiple genetic changes, including APC , KRAS , and TP53 mutations, and the loss of SMAD2 and SMAD4 activities promote CRC development [4–6].…”