© 2004 by Oxford University Press
© 2004 Oxford University Press
ARTICLE |
Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging
Affiliations of authors: Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles; Department of Surgery, West Los Angeles Veteran Affairs Hospital, Los Angeles, CA
Correspondence to: Jessica Beth O’Connell, MD, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Ave., Rm. 72-215 CHS, Los Angeles, CA 90095 (e-mail: jbocjboc{at}hotmail.com)
Background: The recently revised American Joint Committee on Cancer (AJCC) sixth edition cancer staging system increased the stratification within colon cancer stages II and III defined by the AJCC fifth edition system. Using nationally representative Surveillance, Epidemiology, and End Results (SEER) data, we compared survival rates associated with colon cancer stages defined according to both AJCC systems. Methods: Using SEER data (from January 1, 1991, through December 31, 2000), we identified 119 363 patients with colon adenocarcinoma and included all patients in two analyses by stages defined by AJCC fifth and sixth edition systems. Tumors were stratified by SEER’s "extent of disease" and "number of positive [lymph] nodes" coding schemes. Kaplan–Meier analyses were used to compare overall and stage-specific 5-year survival. All statistical tests were two-sided. Results: Overall 5-year survival was 65.2%. According to stages defined by the AJCC fifth edition system, 5-year stage-specific survivals were 93.2% for stage I, 82.5% for stage II, 59.5% for stage III, and 8.1% for stage IV. According to stages defined by the AJCC sixth edition system, 5-year stage-specific survivals were 93.2% for stage I, 84.7% for stage IIa, 72.2% for stage IIb, 83.4% for stage IIIa, 64.1% for stage IIIb, 44.3% for stage IIIc, and 8.1% for stage IV. Under the sixth edition system, 5-year survival was statistically significantly better for patients with stage IIIa colon cancer (83.4%) than for patients with stage IIb disease (72.2%) (P<.001). Conclusions: The AJCC sixth edition system for colon cancer stratifies survival more distinctly than the fifth edition system by providing more substages. The association of stage IIIa colon cancer with statistically significantly better survival than stage IIb in the new system may reflect current clinical practice, in which stage III patients receive chemotherapy but stage II patients generally do not.
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Correspondence about this Article
- Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging
- Stephen B. Edge, Leslie H. Sobin, David L. Page, Mary K. Gospodarowicz, Frederick L. Greene, and David P. Winchester
J Natl Cancer Inst 2005 97: 463-464.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging
- Jessica B. O'Connell, Melinda A. Maggard, and Clifford Y. Ko
J Natl Cancer Inst 2005 97: 464.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging
- Harry B. Burke
J Natl Cancer Inst 2005 97: 464-465.[Extract] [Full Text] [PDF]
- Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging
- Seung-Yong Jeong, David B. Chessin, Deborah Schrag, Elyn Riedel, W. Douglas Wong, and Jose G. Guillem
J Natl Cancer Inst 2005 97: 1705-1706.[Extract] [Full Text] [PDF]
Editorial about this Article
- Outcome Prediction and the Future of the TNM Staging System
- Harry B. Burke
J Natl Cancer Inst 2004 96: 1408-1409.[Extract] [Full Text] [PDF]
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S. B. Edge, L. H. Sobin, D. L. Page, M. K. Gospodarowicz, F. L. Greene, and D. P. Winchester Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging J Natl Cancer Inst, March 16, 2005; 97(6): 463 - 464. [Full Text] [PDF]
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J. B. O'Connell, M. A. Maggard, and C. Y. Ko RESPONSE: Re: Colon Cancer Survival Rates With the New American Joint Committee on Cancer Sixth Edition Staging J Natl Cancer Inst, March 16, 2005; 97(6): 464 - 464. [Full Text] [PDF]
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