Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting
(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 f...
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my.um.eprints.387402023-11-27T07:27:38Z http://eprints.um.edu.my/38740/ Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting Song, Chin-Vern van Gils, Carla H. Yip, Cheng-Har Soerjomataram, Isabelle Taib, Nur Aishah Mohd See, Mee-Hoong Lim, Alexander Satar, Nur Fadhlina Abdul Bhoo-Pathy, Nirmala R Medicine RC Internal medicine (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. MDPI 2023-02 Article PeerReviewed Song, Chin-Vern and van Gils, Carla H. and Yip, Cheng-Har and Soerjomataram, Isabelle and Taib, Nur Aishah Mohd and See, Mee-Hoong and Lim, Alexander and Satar, Nur Fadhlina Abdul and Bhoo-Pathy, Nirmala (2023) Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting. Diagnostics, 13 (4). ISSN 2075-4418, DOI https://doi.org/10.3390/diagnostics13040674 <https://doi.org/10.3390/diagnostics13040674>. 10.3390/diagnostics13040674 |
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R Medicine RC Internal medicine Song, Chin-Vern van Gils, Carla H. Yip, Cheng-Har Soerjomataram, Isabelle Taib, Nur Aishah Mohd See, Mee-Hoong Lim, Alexander Satar, Nur Fadhlina Abdul Bhoo-Pathy, Nirmala Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
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(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. |
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author |
Song, Chin-Vern van Gils, Carla H. Yip, Cheng-Har Soerjomataram, Isabelle Taib, Nur Aishah Mohd See, Mee-Hoong Lim, Alexander Satar, Nur Fadhlina Abdul Bhoo-Pathy, Nirmala |
author_facet |
Song, Chin-Vern van Gils, Carla H. Yip, Cheng-Har Soerjomataram, Isabelle Taib, Nur Aishah Mohd See, Mee-Hoong Lim, Alexander Satar, Nur Fadhlina Abdul Bhoo-Pathy, Nirmala |
author_sort |
Song, Chin-Vern |
title |
Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
title_short |
Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
title_full |
Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
title_fullStr |
Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
title_full_unstemmed |
Discriminatory ability and clinical utility of the AJCC7 and AJCC8 staging systems for breast cancer in a middle-income setting |
title_sort |
discriminatory ability and clinical utility of the ajcc7 and ajcc8 staging systems for breast cancer in a middle-income setting |
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MDPI |
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2023 |
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http://eprints.um.edu.my/38740/ |
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1783876672325419008 |
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13.188404 |