Validation of the eighth edition of the AJCC staging system for patients with pancreatic adenocarcinoma initially receiving chemoradiotherapy and proposal of modifications

Objective:To validate the eighth edition of the AJCC staging system in patients with pancreatic adenocarcinoma receiving only stereotactic body radiation therapy and chemotherapy,and to propose modifications to improve prognostic accuracy.Methods:Patients with pathologically confirmed pancreatic adenocarcinoma without metastasis who were undergoing only chemoradiotherapy were included and staged according to the seventh and eighth editions of the AJCC staging system.Meanwhile,another group of stage T4 patients from the above enrollment with only portal vein involvement with or without tumor thrombi(PV±PVTT)were retrieved for survival comparisons.Modifications were proposed according to the survival comparisons.A cohort from the SEER database was used for external validation of the modified staging system.Results:A total of 683 patients were included.Patients with N2 or N1 but different T stages had significantly different survival outcomes according to the eighth edition.The survival of patients with(PV±PVTT)was comparable to that of patients with T4 tumors.The concordance index of the seventh and eighth editions,and the modified staging system was 0.744(95%CI:0.718—0.769),0.750(95%CI:0.725—0.775),and 0.788(95%CI:0.762-0.813),respectively.For external validation,the concordance index was 0.744(95%CI:0.718-0.770),0.750(95%CI:0.724-0.776),and 0.788(95%CI:0.762-0.814),respectively.Conclusions:The modified staging system is suggested to have the m ost accurate prognostic value.Hence,PV土PVTT should be added to the definition of T4 tumors regardless of tumor size.Patients with N2 or N1 in different T stages could be regrouped into different substages.Additionally,stage III should be subclassified into IIIA(T3N 2 and T4N 0)and IIIB(T4N 1-2).

Impetus for Export-Oriented Economy——Review of foreign capital utilization in Hunan during the Eighth Five-Year Plan period

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CAS TELEMETRIC ACHIEVEMENTS DURING THE EIGHTH FIVE-YEAR PLAN PERIOD

The applied research on remote-sensing technology at our Academy has achieved the envisaged target of scaling a new stage during each of the five year plans. At present, there are some 30 research sections and teams specializing in the subject and staffed by more than 1,700 professionals in the CAS system, including six CAS members and some 500 mid-ranking or senior researchers. It is expected that the number of doctorate and post-doctorate scholars flocking to the field are in rapid increase. During the Sixth Five-year Plan period(1981-1985), the telemetric research at the

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The annual China (Guangzhou) International Automobile Exhibition was held at the China Import and Export Commodity Fair on December 21-27, 2010. This year’s exhibition covered about 160,000 square meters. The world’s

Average Annual Growth of GDP during the Eighth Five-Year Plan Period

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The Lexus CT 200h shines at the eighth China Changchun International Auto Expo

Lexus,the world’s leading luxury car producer,brought its CT200h and six more vehicles to display at the eighth China Changchun International Auto Expo in Changchun,capital of Northeast China’s Jilin Province on July14.

Women Athletes Set Records at the Eighth National Games

Many talented new athletes emerged during China’s Eighth National Games, which were held in Shanghai in October of last year. They broke several world, regional,