Proposed changes to the pathologic staging for colon cancer (CC): AJCC Colon Cancer Expert Panel (AJCCCCEP).

作者：Qian Shi, George J. Chang, Levi Pederson, Elliot A. Asare, Zhaohui Jin, Romain Cohen, Jeffrey A. Meyerhardt, Thierry André, Jeanne Tie, Jesse G. Dixon, Bryan E. Palis, Karla V. Ballman, Greg Yothers, Zeliang Ma, Steven R. Alberts, Chanjuan Shi, M. Kay Washington, Julien Taı̈eb, Scott Steele, Richard M. Goldberg · 发表于：Journal of Clinical Oncology · 年份：2025 · DOI：10.1200/jco.2025.43.16_suppl.3520 · 被引用次数：5 · 研究领域：Genetic factors in colorectal cancer、Colorectal Cancer Treatments and Studies、Colorectal and Anal Carcinomas

3520 Background: Recent analyses highlight nonhierarchical outcomes using the 8 th Edition AJCC staging system for CC. For instance, the 5-year survival rate for stages I and IIIa patients (pts) closely align. Additionally, tumor deposits (TDs) have been established as significant prognostic indicators. The AJCCCCEP commissioned this study to develop an updated pathological staging system for CC focused specifically on pts without distant metastasis (M0), while retaining the existing stage IV classification. Methods: Individual patient data (IPD) from pts diagnosed with cc (2010- 2017) in the NCDB were divided into training (70%) and internal validation (30%) datasets. External validation used IPD from clinical trials. The primary endpoint was overall survival (OS). Risk classification development for M0 pts incorporated ungrouped data on pathologic T categories, the number of involved regional lymph nodes (LN+), and TD counts. Recursive partitioning and regression tree analyses were applied to construct hierarchical staging levels. Pre-specified criteria required survival probabilities to be consecutive and show clear separations using Kaplan-Meier (KM) estimates with pairwise log-rank test P of < 0.005 for the training and < 0.05 for validation analyses. Results: Data from 281,997 pts (median age 67 years, 50% male, 81% white, 55% T3, 19% T4, 44% N+, 26% M+, and 11% with ≥1 TD) were analyzed, with a median follow-up of 7.3 years. The updated staging system (Table) met...