Introduction: Accurate staging is essential in pancreatic adenocarcinoma due to its aggressive nature and poor prognosis. The 8th edition of the AJCC TNM staging system introduced changes in tumor size criteria and nodal classification. This study compares the prognostic performance of the 7th and 8th editions in resected patients.Material and Methods: A retrospective analysis was conducted on 214 patients with pancreatic adenocarcinoma who underwent curative surgery. TNM staging was assigned according to both AJCC editions. Kaplan–Meier analysis and multivariate Cox regression, stratified by adjuvant therapy, were used to assess disease-free survival (DFS) and overall survival (OS).Results: The 8th edition TNM staging was significantly associated with lower risk of recurrence, with TNM stages I and II independently predicting better DFS (p< 0.05). In contrast, the 7th edition TNM stage I remained the only independent predictor of OS (HR = 0.376;p= 0.023). Reclassification between editions altered stage distribution, particularly within stage II.Conclusions: The 8th edition improves early recurrence stratification, while the 7th edition retains stronger prognostic value for overall survival. Both systems offer complementary insights, supporting outcome-specific staging use.
引言：胰腺腺癌因其侵袭性强、预后不良的特点，准确分期至关重要。美国癌症联合委员会（AJCC）第八版TNM分期系统对肿瘤大小标准和淋巴结分类进行了修订。本研究比较了第七版与第八版分期系统在根治性手术患者中的预后评估效能。 材料与方法：本研究回顾性分析了214例接受根治性手术的胰腺腺癌患者。根据AJCC两个版本分别进行TNM分期。采用Kaplan-Meier分析和按辅助治疗分层的多变量Cox回归模型评估无病生存期（DFS）和总生存期（OS）。 结果：第八版TNM分期与较低的复发风险显著相关，其中TNM I期和II期是DFS的独立有利预测因素（p<0.05）。相比之下，第七版TNM I期仍是OS的唯一独立预测因子（HR=0.376；p=0.023）。版本间的重新分类改变了分期分布，尤其在II期患者中表现明显。 结论：第八版分期系统在早期复发风险分层方面有所改进，而第七版分期对总生存期仍具有更强的预后价值。两种系统可提供互补信息，支持根据特定临床结局选择适用的分期标准。
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