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Original Article
- Enhancing TNM Stage Completeness Using the SEER Summary Stage: A Nationwide Study From Korea
- Chang Kyun Choi, Mina Suh, Kyu-Won Jung, E Hwa Yun
- J Prev Med Public Health. 2025;58(4):415-421. Published online April 23, 2025
- DOI: https://doi.org/10.3961/jpmph.25.099
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Abstract
Summary
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Supplementary Material - Objectives
Accurate and complete cancer staging is essential for effective prognosis and treatment planning. This study investigated the feasibility of enhancing the completeness of tumor‐node‐metastasis (TNM) staging by integrating Surveillance, Epidemiology, and End Results (SEER) Summary Stage data.
Methods
We analyzed data from 5 cancer types (stomach, colorectum, liver, lung, and breast) in Korea (2012-2017). The study assessed the impact of supplementing missing TNM information with SEER Summary Stage data on both staging completeness and 5‐year relative survival rates.
Results
The study included 173 061 stomach cancer, 159 199 colorectal cancer, 89 639 liver cancer, 137 103 lung cancer, and 110 286 breast cancer patients. The percentage of missing TNM stage data varied by cancer type, ranging from 65.1% (breast cancer) to 93.0% (liver cancer). Supplementation significantly reduced missing values—most notably in stomach cancer, where missing data dropped by 50.6 percentage points (%p), followed by liver (21.5%p) and breast cancers (13.6%p). For stomach cancer, supplementation led to a 3.6%p decrease in stage I survival rates, whereas liver cancer exhibited the most pronounced changes, with stage IV survival rates declining from 17.7% to 7.9%.
Conclusions
Integrating SEER Summary Stage data enhances TNM staging completeness. However, further evaluation incorporating treatment information is essential. -
SummaryKorean summary
본 연구는 한국 등록통계에서 SEER 요약 병기 데이터를 활용해 TNM 병기 분류 완전성 향상 가능성을 평가하였다. 데이터 보완을 통해 다섯 가지 암종에서 누락률이 최대 50.6%포인트 감소하였으나, 5년 상대 생존율은 대체로 큰 변화가 없었다. 다만 간암 등 일부 암종에서 생존율 변화가 현저하여 치료 정보 등의 추가적인 통합 평가가 필요하다.Key Message
This study evaluated the feasibility of improving the completeness of tumor-node-metastasis (TNM) staging by integrating Surveillance, Epidemiology, and End Results (SEER) Summary Stage data. Data supplementation significantly reduced the proportion of missing TNM information across five cancer types, including a 50.6 percentage point decrease for stomach cancer, while generally resulting in minimal changes to 5-year relative survival rates. However, notable changes were observed in liver cancer, where stage IV survival rates markedly declined from 17.7% to 7.9%, highlighting the need for further evaluation that incorporates treatment information.
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