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Melanoma Prognosis - Accuracy of the American Joint Committee on Cancer Staging Manual Eighth Edition.

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Abstract:

BACKGROUND:The American Joint Committee on Cancer (AJCC) maintains that the eighth edition of its Staging Manual (AJCC8) has improved accuracy compared to the seventh (AJCC7). However, there are concerns that implementation may disrupt analysis of active clinical trials for stage III patients. We used an independent cohort of melanoma patients to test the extent to which AJCC8 has improved prognostic accuracy compared to AJCC7. METHODS:We analyzed a cohort of 1,315 prospectively enrolled patients. We assessed primary tumor and nodal classification of stage I-III patients using AJCC7 and AJCC8 to assign disease stages at diagnosis. We compared recurrence-free (RFS) and overall survival (OS) using Kaplan-Meier curves and log-rank tests. We then compared concordance indices of discriminatory prognostic ability and area under the curve (AUC) of 5-year survival to predict RFS/OS. All statistical tests were two-sided. RESULTS:Stage IIC continued to have worse outcomes than those for stage IIIA patients, with 5-year RFS of 26.5% (95%CI=12.8-55.1%) vs. 56.0% (95%CI=37.0-84.7%) by AJCC8 (P = 0.002). For stage I, removing mitotic index as T classification factor decreased its prognostic value, although not statistically significantly (RFS C-index=0.63 [95%CI=0.56-0.69] to 0.56 [95%CI=0.49-0.63], P = 0.07; OS C-index=0.48 [95%CI=0.38-0.58] to 0.48 [95%CI=0.41-0.56], P = 0.90). For stage II, prognostication remained constant (RFS C-index=0.65 [95%CI=0.57-0.72]; OS C-index=0.61 [95%CI=0.50-0.72]), and. For stage III, AJCC8 yielded statistically significantly enhanced prognostication for RFS (C-index=0.65 [95%CI=0.60-0.70] to 0.70 [95%CI=0.66-0.75], P = 0.01). CONCLUSIONS:Compared with AJCC7, we demonstrate that AJCC8 enables more accurate prognosis for patients with stage III melanoma. Restaging a large cohort of patients can enhance the analysis of active clinical trials.

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JNCI-Journal of the National Cancer Institute

JNCI-J NATL CANCER I
最新影响因子:11.577 期刊ISSN:0027-8874 CiteScore:
出版周期: 是否OA:YES 出版年份:0

期刊官方网址:http://jnci.oxfordjournals.org/

期刊投稿地址:

自引率:1.60% 研究方向:ONCOLOGY-
出版地区:UNITED STATES

SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)

NCBI查询:PubMed Central (PMC)链接全文检索(pubmed central)

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JNCI-Journal of the National Cancer Institute 期刊简介

英文简介:

Publishing the best original research papers in oncology from around the world and internationally acclaimed as the source for the most up-to-date information, the Journal of the National Cancer Institute is now available by subscription from Oxford University Press. Each issue is also packed with extensive news about important cancer-related science, policy, politics, and people. In addition, there are editorials and reviews by experts in the field, book reviews, and commentaries on timely topics. The Journal of the National Cancer Institute publishes manuscripts that describe new findings of particular significance in any area relating to cancer, as well as associated news items, reviews, and opinion pieces. The Journal employs a process of rigorous yet rapid review of submitted manuscripts so that findings of high scientific and medical interest can be published with minimum delay.

中文简介:(来自Google、百度翻译)

《国家癌症研究所学报》是牛津大学出版社出版的最新信息来源之一,发表了世界各地和国际上最优秀的肿瘤学原始研究论文。每一期都充斥着与癌症有关的重要科学、政策、政治和人民的广泛新闻。此外,还有该领域专家的社论和评论、书评和适时主题评论。《国家癌症研究所杂志》出版的手稿描述了与癌症有关的任何领域的特别重要的新发现,以及相关的新闻项目、评论和评论文章。该杂志采用了一个严格而快速的审查提交的手稿的过程,以便高科学和医学利益的调查结果可以在最短的时间内出版。

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JNCI-Journal of the National Cancer Institute 期刊中科院评价数据

最新中科院分区

大类(学科) 小类(学科) 学科排名
医学 ONCOLOGY(肿瘤学) 1区
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年度总发文量 年度论文发表量 年度综述发表量
133 111 22
总被引频次:36790
特征因子:0.051650

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每篇文章中来源出版物的标准化影响将实际受引用情况对照期刊所属学科领域中预期的受引用情况进行衡量。

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    liting7111

    审稿时间: 2个月内 接受率: 比较困难(25%命中)

    去年8月份投稿的,几天就送审了,审了两个月大修,三个审稿人,其中一个是统计,提了五十多个问题,可以看出审稿人文章看的很仔细,一个月小修,又花了一个月修改格式,今年2月顺利接收了,两周在线。效率很高,还不收费,文章够新的可以尝试投稿。
    2020-04-08

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