Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Vanderbilt staging best for predicting overall survival in retroperitoneal sarcoma

Huggett B & Cates J. Modern Pathology; 5 Nov. 2018.

Key clinical point: The Vanderbilt staging system for retroperitoneal sarcoma is better than the 7th and 8th editions of the AJCC (American Joint Committee on Cancer) staging systems for risk stratification and predicting 5-year survival.

Major finding: The revised AJCC 8th edition T categories were not effective in categorizing risk of death. The Vanderbilt staging system showed the best discrimination between adjacent tumor stages, highest predictive accuracy for 5-year overall survival, a higher degree of concordance with and explained variation of clinical outcomes, and resulted in the best fitting regression model.

Study details: An independent cohortof 6,957 patients in the National Cancer Database was used to validate the staging systems. Each staging system was assessed for degree of discrimination by pairwise comparisons of adjacent stage categories. Predictive accuracy of 5-year overall survival was performed by comparison of areas under receiver operating characteristic curves generated from logistic regression. Three different concordance indices (Harrell’s c, Somers’ D, and Gönen and Heller’s K) were calculated using bootstrap methods.

Disclosures: The researchers had no relevant financial disclosures.

Source: Huggett B & Cates J. Modern Pathology; 5 Nov. 2018.


Huggett B & Cates J. Modern Pathology; 5 Nov. 2018.