Purpose We aimed to emphasize the prognostic impact of differences included in the
8th versus the previous 7th edition of AJCC (American Joint Committee on Cancer) Cancer
Staging manual for hepatocellular carcinoma (HCC). Methods A number of 87 consecutive
HCCs were retrospectively evaluated and staged, using the 7th and 8th edition of AJCC
staging systems. The clinicopathological parameters were correlated with the overall
survival rate. No preoperative chemotherapy was received by any of the patients. Results
According to the 7th edition of AJCC manual, 52 of the 87 cases were staged as pT2
and 35 as pT1. After restaging, according to the 8th edition, 23 of the 52 pT2 cases
were understaged as pT1b, and the rest of the 29 remained as pT2. Regarding the 35
HCCs classified as pT1, using 7th edition, all of them were restaged as pT1a. Compared
to the 7th staging system, using the 8th edition of AJCC manual, the percentage of
pT2 tumors significantly decreased, from 59.77 to 33.33%. The patient's gender, age,
tumor focality, and grade of differentiation did not prove to have any prognostic
value. Regarding pT stage, it does not influence the overall survival rate, independently
from the used staging system. Conclusion The staging criteria, in the most recent
edition of AJCC, are simplified and allowed tumor understaging. These changes do not
have independent prognostic value. The prognostic impact of pT understaging should
be evaluated in larger cohorts.
