A Proposal for Future Modifications on Clinical TNM Staging System of Retinoblastoma Based on the American Joint Committee on Cancer Staging Manual, 7<sup>th</sup> and 8<sup>th</sup> Editions
Yacoub A. Yousef, Ibrahim Qaddoumi, Ibrahim AlNawaiseh, Mona Mohammad, Dalia Al-Rimawi, Mario Damiano Toro, Sandrine Zweifel, Robert Ręjdak, Rashed Mustafa Nazzal, Mustafa Mehyar, Imad Jaradat, Iyad Sultan, Maysa Al‐Hussaini
Abstract
Importance: The 8 th edition of the American Joint Committee on Cancer (AJCC) staging manual incorporated new changes from its 7 th edition for classifying retinoblastoma (RB). Objective: We assessed the comparative prognostic values of the 7 th and 8 th editions of the AJCC clinical (cTNM) staging manuals for RB and suggested modifications for future edition accordingly. Design: A retrospective, observational study. Setting: King Hussein Cancer Centre. Participants: A cohort of 478 patients and 565 eyes with RB. Main Outcomes and Measures: Main outcome measures included demographics; tumor features, AJCC cTNM stage, and eye salvage rates. The prognostic performance of the different staging systems was assessed with the concordance index (C-index) and likelihood ratio 2 tests.