Validation of the 7th AJCC/UICC staging system for gastric cancer and a proposal for a new TNM system based on a prognostic score: a retrospective multicenter study.
10.4174/astr.2016.91.6.295
- Author:
Oh Kyoung KWON
1
;
Se Won KIM
;
Hyun Dong CHAE
;
Seung Wan RYU
;
Ho Young CHUNG
;
Sang Woon KIM
;
Won Kee LEE
;
Wansik YU
Author Information
1. Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea. okugisurg@knu.ac.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
TNM classification;
Stomach neoplasms
- MeSH:
Daegu;
Discrimination (Psychology);
Gastrectomy;
Hospitals, University;
Humans;
Joints;
Korea;
Population Characteristics;
Retrospective Studies*;
Stomach Neoplasms*;
Survival Rate
- From:Annals of Surgical Treatment and Research
2016;91(6):295-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We validate the 7th American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging system for gastric cancer and propose a new staging system that reflects the prognostic significances of each of T and N category. METHODS: Data from 5,957 patients who underwent curative gastrectomies from 2000 to 2007 at 4 university hospitals in Daegu Metropolitan city in Korea were analyzed for the validation of the 7th AJCC/UICC staging system for gastric cancer. The hazard ratios of the respective T and N categories were estimated and converted to weightings and summated to make prognostic score (P-score). Homogeneity and stage grouping were determined according to the P-scores. RESULTS: In the 7th AJCC/UICC staging system for gastric cancer, poor discrimination was noted between stages IIB and IIIA (P = 0.152). In addition, heterogeneity in stage IIB (P = 0.021) and a small gap in 5-year survival rates (1.7%) between stages IA and IB were noted. A new proposed staging system was generated on the basis of P-scores and demonstrated more discrimination between stages and more homogeneity within stages. The new staging system reflects the different prognostic impacts of N3a and N3b. CONCLUSION: Several controversial issues of the 7th AJCC/UICC staging system for gastric cancer were reconfirmed in the present analysis. The TNM system based on P-score appears to be more scientifically accurate than the 7th AJCC/UICC staging system for gastric cancer.
