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Sun Z, Sun X, Guo J, Li X, Wang Q, Su N, Chen M, Cao G, Yu Y, Wang M, Li H, Zhong H, Zou H, Ma K, Shen F, Zhang B, Sun X, Feng Y. Prognostic influence for hilar cholangiocarcinoma and comparisons of prognostic values of Mayo staging and TNM staging systems. Medicine (Baltimore) 2022; 101:e32250. [PMID: 36626512 PMCID: PMC9750704 DOI: 10.1097/md.0000000000032250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The study was designed to discuss the effect of stratification factors in the Mayo staging on the prognosis of hilar cholangiocarcinoma (HCCA) patients, and to evaluate the predictive value of the Mayo staging on the prognosis. The Kaplan-Meier survival curve and Log-rank test were used to perform univariate analysis on each index and obtain statistically significant influencing factors. The Kaplan-Meier survival curve and Log-rank test were used to analyze the correlation between the two staging systems and the survival period. The receiver operating characteristic (ROC) curves were used for each single staging system trend analysis, and comparison of their curve area to determine prognosis prediction ability for patients with HCCA. According to Kaplan-Meier survival curve changes and Log-rank test results, it was found that both staging systems were correlated with the survival time of the patients (P < .001). Through a pairwise comparison within the stages, it was found that the heterogeneity between the stages within the Mayo staging is very good, which was better than the TNM staging. A single trend analysis of the prognostic assessment capabilities of the two systems found that the area under the ROC curve of Mayo staging system (AUC = 0.587) was the largest and better than the TNM staging system (AUC = 0.501). Mayo staging can be used for preoperative patient prognosis assessment which can provide better stratification ability based on a single-center small sample study, and the predictive value is better than TNM staging.
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Affiliation(s)
- Zhaowei Sun
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
- * Correspondence: Yujie Feng, Department of Hepatobiliary Surgery, Affliated Hospital of Qingdao University, Jiangsu 16, Qingdao 26000, China (e-mail: )
| | - Xiaozhi Sun
- Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jingyun Guo
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xueliang Li
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qinlei Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Na Su
- Medical Imaging Department, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Menshou Chen
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guanghua Cao
- Department of Hepatobiliary and Pancreatic Surgery, HuiKang Hospital of Qingdao, Shandong, China
| | - Yanan Yu
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Maobing Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haoran Li
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haochen Zhong
- Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hao Zou
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Kai Ma
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fangzhen Shen
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bingyuan Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaozhi Sun
- Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yujie Feng
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Abstract
Tumour volume is a significant prognostic factor in the treatment of malignant head and neck tumours. Studies of laryngeal and pharyngeal tumours have shown tumour volume to be an important predictor for tumour recurrence. Some studies (for instance nasopharyngeal carcinoma) have shown through multivariate modelling that tumour volume is a dominant covariate that overwhelms T stage, N stage and stage group. The results of these studies have prompted several investigators to suggest the inclusion of tumour volume as an additional prognostic factor in future revisions of the TNM staging system. This paper briefly reviews the TNM system as a staging tool, the measurement of tumour volume and how tumour volume could possibly be incorporated in the system or used as an additional prognostic factor.
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Affiliation(s)
- Vincent F H Chong
- Department of Diagnostic Radiology, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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