44O - Validation of the prognostic value of 8th edition revisions of the AJCC staging system for non-small cell lung cancer: A SEER database analysis

Date 07 May 2017
Event ELCC 2017
Session SCLC and early stage NSCLC
Presenter Omar Abdel-Rahman
Citation Annals of Oncology (2017) 28 (suppl_2): ii14-ii16. 10.1093/annonc/mdx086
Authors O. Abdel-Rahman
  • Clinical Oncology, Ain Shams university Faculty of medicine, 113331 - Cairo/EG

Abstract

Background

The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for non-small cell lung cancer (NSCLC) has been released. The current study seeks to validate the prognostic significance of the new system 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. Overall and lung cancer-specific survival analyses according to both 7th and 8th editions were conducted through Kaplan-Meier analysis and multivariate analysis was conducted through a Cox proportional hazard model.

Results

A total of 127096 patients with NSCLC were identified in the period from 2010-2013. For overall survival assessment according to the 8th edition, P values for all pair wise comparisons among different stages were significant (<0.0001) except for the comparison between stage IIA and stage IIB (P = 0.102). For lung cancer-specific survival according to the 8th edition, P values for all pair wise comparisons among different stages were significant (<0.0001). Among patients with stage I disease, multivariate analysis for factors affecting overall and lung cancer-specific survival among patients with stage I disease was conducted. The following factors were associated with worse overall and lung cancer-specific survival (age ≥ 70 years, more advanced stage, male gender, squamous histology, no surgery and no radiotherapy) (P < 0.0001 for all factors).

Conclusions

This SEER analysis supports the prognostic significance of the added sub-stages described within AJCC 8th edition stages I and III. Further work is needed to incorporate molecular markers and personalize the future editions of the AJCC staging system.

Clinical trial identification

Legal entity responsible for the study

Omar Abdel-Rahman

Funding

Omar Abdel-Rahman

Disclosure

The author has declared no conflicts of interest.