Validation of AJCC TNM staging for breast tumors diagnosed before 2004 in cancer registries

Purpose: American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N), and Metastatic (M) staging is commonly used in clinical practice for treatment decisions, yet before 2004, Surveillance Epidemiology and End Results (SEER)-affiliated cancer registries did not routinely include TNM staging defi...

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Bibliographic Details
Published in:Cancer causes & control 2012-09, Vol.23 (9), p.1587-1591
Main Authors: Kwan, Marilyn L., Haque, Reina, Lee, Valerie S., Chung, W-L Joanie, Avila, Chantal C., Clancy, Heather A., Quinn, Virginia P., Kushi, Lawrence H.
Format: Article
Language:English
Subjects:
Agreements
Algorithms
Annual reports
Biomedical and Life Sciences
Biomedicine
Breast cancer
Breast neoplasms
Breast Neoplasms - diagnosis
Breast Neoplasms - pathology
BRIEF REPORT
Cancer
Cancer Research
Clinical medicine
Committees
Epidemiology
Female
Hematology
Humans
Lymph nodes
Lymphatic system
Medical prognosis
Metastasis
Neoplasm staging
Neoplasm Staging - methods
Oncology
Pathology
Prophets
Public Health
Registries
Sensitivity
Sensitivity and Specificity
Surveillance
Tumors
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Summary:Purpose: American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N), and Metastatic (M) staging is commonly used in clinical practice for treatment decisions, yet before 2004, Surveillance Epidemiology and End Results (SEER)-affiliated cancer registries did not routinely include TNM staging defined by AJCC criteria, reporting instead SEER Summary Staging. Methods: We developed and validated an algorithm to determine AJCC TNM staging from Extent of Disease information for 17,133 female breast cancer cases diagnosed from 1988 to 2003 in the cancer registries of Kaiser Permanente Northern and Southern California. Test characteristics (percent agreement, Cohen's kappa, sensitivity, specificity) were calculated to compare derived TNM with gold-standard TNM available in the registry. Results: Agreement for TNM variables was excellent (range 0.91-1.00 for percent agreement and Cohen's kappa). The sensitivity and specificity, respectively, of the algorithm for AJCC TNM Version 6 staging were as follows: Stage 0 (0.99, 1.00), Stage I (0.97, 0.98), Stage II (0.91, 0.96), Stage III (0.69, 0.99), and Stage IV (0.92, 1.00). Stage III had lower sensitivity due to reclassification of supraclavicular lymph node positivity from M1 (Stage IV) to N3 (Stage IIIC) in AJCC Version 6. Conclusions: Derived AJCC staging for breast tumors diagnosed before 2004 is feasible and accurate using cancer registry data.
ISSN:0957-5243
1573-7225
DOI:10.1007/s10552-012-0026-7