Bibliographic Details
| Title: |
Discriminatory Ability and Clinical Utility of the AJCC7 and AJCC8 Staging Systems for Breast Cancer in a Middle-Income Setting |
| Authors: |
Chin-Vern Song, Carla H. van Gils, Cheng-Har Yip, Isabelle Soerjomataram, Nur Aishah Mohd Taib, Mee-Hoong See, Alexander Lim, Nur Fadhlina Abdul Satar, Nirmala Bhoo-Pathy |
| Source: |
Diagnostics, Vol 13, Iss 4, p 674 (2023) |
| Publisher Information: |
MDPI AG, 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Medicine (General) |
| Subject Terms: |
breast cancer, AJCC7, AJCC8, low- and middle-income countries, prognostic performance, clinical utility, Medicine (General), R5-920 |
| More Details: |
(1) Background: Differences in access to biomarker testing and cancer treatment in resource-limited settings may affect the clinical utility of the AJCC8 staging system compared to the anatomical AJCC7 system. (2) Methods: A total of 4151 Malaysian women who were newly diagnosed with breast cancer from 2010 to 2020 were followed-up until December 2021. All patients were staged using the AJCC7 and AJCC8 systems. Overall survival (OS) and relative survival (RS) were determined. Concordance-index was used to compare the discriminatory ability between the two systems. (3) Results: Migration from the AJCC7 to AJCC8 staging system resulted in the downstaging of 1494 (36.0%) patients and the upstaging of 289 (7.0%) patients. Approximately 5% of patients could not be staged using the AJCC8 classification. Five-year OS varied between 97% (Stage IA) and 66% (Stage IIIC) for AJCC7, and 96% (Stage IA) and 60% (Stage IIIC) for AJCC8. Concordance-indexes for predicting OS using the AJCC7 and AJCC8 models were 0.720 (0.694–0.747) and 0.745 (0.716–0.774), and for predicting RS they were 0.692 (0.658–0.728) and 0.710 (0.674–0.748), respectively. (4) Conclusions: Given the comparable discriminatory ability between the two staging systems in predicting the stage-specific survival of women with breast cancer in the current study, the continued use of the AJCC7 staging system in resource-limited settings seems pragmatic and justifiable. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2075-4418 |
| Relation: |
https://www.mdpi.com/2075-4418/13/4/674; https://doaj.org/toc/2075-4418 |
| DOI: |
10.3390/diagnostics13040674 |
| Access URL: |
https://doaj.org/article/e832a01f93b54dc6a0e67002928262e9 |
| Accession Number: |
edsdoj.832a01f93b54dc6a0e67002928262e9 |
| Database: |
Directory of Open Access Journals |
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