Verification of the Japanese staging system for rectal cancer, focusing on differences with the TNM classification

Persistent ID (NDL): info:ndljp/pid/12769040

Material type: 博士論文

Author: Arabiki, Michiru

Publisher: -

Publication date: 2022-03-23

Material Format: Digital

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Name of awarding university/degree: 新潟大学,博士（医学）

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Note (General)：: Purpose The 9th Japanese Classification of Colorectal Cancer (9th JSCCR) has two main differences from the TNM classification (8th AJCC): first, main ...

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Material Type: 博士論文
Title: Verification of the Japanese staging system for rectal cancer, focusing on differences with the TNM classification
Author/Editor: Arabiki, Michiru
Author Heading: Arabiki, Michiru
Publication Date: 2022-03-23
Publication Date (W3CDTF): 2022-03-23
Alternative Title: 日本における直腸癌の臨床病期の検証 : TNM分類との違いに着目して
Degree grantor/type: 新潟大学
Date Granted: 2022-03-23
Date Granted (W3CDTF): 2022-03-23
Dissertation Number: 甲第5002号
Degree Type: 博士（医学）
Text Language Code: eng
Alias of Author: 荒引, みちる
Subject Heading: Rectal cancer
The Japanese staging system
Whole-mount section
TNM classification
Akaike information criterion
Target Audience: 一般
Note (General): Purpose The 9th Japanese Classification of Colorectal Cancer (9th JSCCR) has two main differences from the TNM classification (8th AJCC): first, main or lateral lymph node metastasis is classified as jN3; second, tumor nodules (ND) are treated as lymph node metastasis. In this study, we verified the 9th JSCCR for rectal cancer, focusing on the differences with the 8th AJCC. Methods This retrospective analysis involved 212 patients with stage I-III rectal cancer. ND was evaluated using wholemount sections. We evaluated the relapse-free survival of each staging system, and compared the prognostic significance of the different staging systems using the Akaike information criterion (AIC) and Harrell's concordance index (c-index). Results Main or lateral lymph node metastasis was detected in nine of 212 (4%) patients. ND was detected in 79 of 212 (37%) patients. The best risk stratification power was observed in the 9th JSCCR (AIC, 759; c-index, 0.708) compared with the 7th JSCCR (AIC, 771; c-index, 0.681), 8th JSCCR (AIC, 768; c-index, 0.696), and the 8th AJCC (AIC, 766; c-index, 0.691). Conclusions The 9th JSCCR, which includes the concepts of jN3 and ND, is useful for the risk stratification of rectal cancer, and the contributes to precise decision-making for follow-up management and adjuvant therapy.
Surgery today. 2020, 50(11), 1443-1451.
新大院博(医)第1072号
Persistent ID (NDL): info:ndljp/pid/12769040
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Acquisition Basis: 博士論文（自動収集）
Date Accepted (W3CDTF): 2023-04-07T23:08:38+09:00
Format (IMT): application/pdf
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Periodical Title (URI): http://hdl.handle.net/10191/0002000858
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