EVALUATION OF UICC TNM CLASSIFICATION FOR PANCREATIC-CANCER - A STUDYOF 228 PATIENTS

Conclusion. A different stage grouping of TNM factors can improve the predictivity of the UICC TNM classification for pancreatic cancer. Nev ertheless, the Japanese Pancreas Society (JPS) classification maintain s a higher prognostic value. Background. The use of a reliable staging classification facilitates the evaluation of anticancer treatments an d the correct management of patients. The aim of the present study was to evaluate the prognostic value of three modified UICC TNM classific ations, obtained by different stage grouping of the UICC TNM factors, comparing their predictivity to the standard UICC and the JPS classifi cations. Methods. Clinical material consisted of 228 patients who unde rwent resection for pancreatic cancer. The reliability of the classifi cations was analyzed by the following methods: univariate analysis of stage survival curves; multivariate analysis of each classification af ter adjusting for grading and radicality; and correlation between the patients' distribution in the stages of each classification and in sur vival classes. Results. The following modified UICC classification all owed a better differentiation of stage II and III survival (P = 0.08) than standard UICC (P = 0.74): stage I: TINOMO; stage II: T1N1MO/T2NOM O: stage III: T2N1MO/T3 any NMO; stage IV: M1. The JPS classification better discriminated between the different stages (P < 0.001). All cla ssifications had an independent prognostic value by multivariate analy sis. The correlation between stages and survival classes was higher fo r the JPS classification than either UICC TNM classification or the mo dified UICC classifications.