The “T” now Matters: The Eighth Edition of the Union for International Cancer Control Classification of Pancreatic Adenocarcinoma

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Abstract

Background:

The new 8th edition of the Union for International Cancer Control (UICC) classification of TNM staging includes relevant changes for pancreatic cancer (PC). We report on the survival stratification of the new T and N stages.

Methods:

The 8th edition TNM system was retrospectively applied to patients who underwent curative PC resection at our institution between 2005–2015.

Results:

Some 256 patients were included. The postoperative TNM stage was pT3 in 96% of the cases according to the 7th edition of UICC staging. When the 8th edition system –which stratifies by tumor size and number of involved lymph nodes– was applied, both T- and N-stage were significant prognostic survival factors. Most interestingly, the old pT3 subgroup was split into four different pT stages of the 8th edition system with the most frequent stage being pT2 (58.6%). In this subgroup, patients with pT1–2 and pT3 tumors had a significantly different survival (P = 0.0474).

Conclusions:

Compared with the 7th edition of UICC TNM staging, the new N, but also the T system can better discriminate the overall survival of PC patients.

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