The standard for cancer staging in the United States for all cancer sites, including primary carcinomas of the appendix, is the American Joint Committee on Cancer (AJCC) staging system. AJCC staging criteria undergo periodic revisions, led by a panel of site-specific experts, to maintain contemporary staging definitions through the evaluation of new evidence. Since its last revision, the AJCC has restructured its processes to include prospectively collected data because large data sets have become increasingly robust and available over time. Thus survival analyses using AJCC eighth edition staging criteria were used to inform stage group revisions in the version 9 AJCC staging system, including appendiceal cancer. Although the current AJCC staging definitions were maintained for appendiceal cancer, incorporating survival analysis into the version 9 staging system provided unique insight into the clinical challenges in staging rare malignancies. This article highlights the critical clinical components of the now published version 9 AJCC staging system for appendix cancer, which (1) justified the separation of three different histologies (non-mucinous, mucinous, signet-ring cell) in terms of prognostic variance, (2) demonstrated the clinical implications and challenges in staging heterogeneous and rare tumors, and (3) emphasized the influence of data limitations on survival analysis for low-grade appendiceal mucinous neoplasms.

中文翻译：

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生存结果用于验证美国癌症联合委员会阑尾癌分期系统第 9 版


美国所有癌症部位（包括阑尾原发癌）的癌症分期标准是美国癌症联合委员会 (AJCC) 分期系统。 AJCC 分期标准由特定地点专家小组领导定期修订，以通过评估新证据来维持当代分期定义。自上次修订以来，AJCC 重组了其流程，以纳入前瞻性收集的数据，因为随着时间的推移，大型数据集变得越来越强大和可用。因此，使用 AJCC 第八版分期标准进行的生存分析被用来通知第 9 版 AJCC 分期系统中的分期组修订，包括阑尾癌。尽管阑尾癌维持了当前的 AJCC 分期定义，但将生存分析纳入第 9 版分期系统为罕见恶性肿瘤分期的临床挑战提供了独特的见解。本文重点介绍了现已发布的第 9 版阑尾癌 AJCC 分期系统的关键临床组成部分，该系统 (1) 在预后方差方面证明了三种不同组织学（非粘液性、粘液性、印戒细胞）的分离是合理的，（ 2）展示了异质性和罕见肿瘤分期的临床意义和挑战，（3）强调了数据限制对低级别阑尾粘液性肿瘤生存分析的影响。