scholarly journals Comparison of the eighth and seventh editions of the American Joint Committee on Cancer TNM staging systems for gastric cancer: Proposal for a simplified and improved TNM staging system

2017 ◽  
Vol 28 ◽  
pp. v214
Author(s):  
J. Lin ◽  
H. Chang-Ming ◽  
J. Lin ◽  
C. Zheng ◽  
P. Li
Keyword(s):  
Gastric Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
American Joint Committee ◽  
Tnm Staging System ◽  
Staging Systems

scholarly journals Comparing prognostic values of the 7th and 8th editions of the American Joint Committee on Cancer TNM staging system for gastric cancer

2019 ◽  
Vol 35 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Ming-hua Zhu ◽  
Ke-cheng Zhang ◽  
Ze-long Yang ◽  
Zhi Qiao ◽  
Lin Chen
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Staging System ◽  
Tnm Staging ◽  
American Joint Committee ◽  
Tnm Staging System ◽  
Staging Systems ◽  
Gastric Cancer Patients ◽  
8Th Edition

Background and Aim: Our aim was to compare the prognostic value of the American Joint Committee on Cancer (AJCC) 7th and 8th editions staging systems for patients with gastric cancer in China. Methods: A total of 1326 gastric cancer patients diagnosed between 2008 and 2012 were included. The discriminative ability of the AJCC 8th and 7th editions was compared using the Harrell’s concordance index (C-index). Results: There are two main modifications in the 8th edition. (i) pN3 staging was divided into pN3a and pN3b. The gastric cancer patients with pN3a experienced significantly better overall survival compared with those with pN3b (5-year overall survival: 34.5% vs. 15.6%, P < 0.001) (stratified by pT: pT3: 5-year overall survival: 33.9% vs. 13.2%, P < 0.001; pT4a: 32.8% vs. 16.9%, P = 0.056; pT4b: 17.0% vs. 11.1%, P = 0.048). (ii) Subgroup staging adjustments. The subgroup staging adjustments (T3N3bM0 (IIIB→IIIC), T4aN3aM0 (IIIC→IIIB), T4bN0M0 (IIIB→IIIA), and T4bN2M0 (IIIC→IIIB)) resulted in more gastric cancer patients being accurately staged. Furthermore, the C-index value of the 8th edition tumor node metastasis (TNM) staging system was significantly higher than that of the AJCC 7th TNM staging system to predict the survival of gastric cancer patients (0.701 vs. 0.685, P < 0.001). Conclusions: The 8th edition of the TNM staging system is superior to the 7th edition staging system for prediction of survival of gastric cancer patients in China.

scholarly journals Evaluation of the Eighth Edition of the American Joint Committee on Cancer TNM Staging System for Gastric Cancer: An Analysis of 7371 Patients in the SEER Database

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Long-Long Cao ◽  
Jun Lu ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
Jia-Bin Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rates ◽  
Stage Iv ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Migration ◽  
Seer Database ◽  
Tnm System ◽  
American Joint Committee ◽  
Tnm Staging System

Objective. To investigate the validity of the 8thedition of the American Joint Committee on Cancer (AJCC) TNM staging system for gastric cancer.Methods. The clinicopathologic data of 7371 patients who were diagnosed with gastric cancer and had 16 or more involved lymph nodes (LNs) were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and retrospectively reviewed.Results. Stage migration occurred primarily during stage III between the 7thand 8thedition TNM staging systems. Stages IIIB and IIIC in the 7thedition staging system were divided in the 8thedition and had obvious differences in survival rates (bothP<0.001). The 8thedition TNM stages IIIC and IV showed similar survival rates (P=0.101). The prognosis of patients with T4aN3bM0 was not different from that of patients with TxNxM1 (P=0.433), while the prognosis of patients with T4bN3bM0 was significantly poorer than that of patients with TxNxM1 (P=0.008). A revised TNM system with both T4aN3bM0 and T4bN3bM0 incorporated into stage IV was proposed. Multivariable regression analysis showed that the revised TNM system, but not the 7thand 8theditions, was an independent factor for disease-specific survival (DSS) in the third step of the analysis. Further analyses revealed that the revised TNM system had superior discriminatory ability to the 8thedition staging system, which was also an improvement over the 7thedition staging system.Conclusion. The 8thedition of the AJCC TNM staging system is superior to the 7thedition for predicting the DSS rates of gastric cancer patients. However, for better prognostic stratification, it might be more suitable for T4aN3bM0/T4bN3bM0 to be incorporated into stage IV in the 8thedition TNM staging system.

Validation of the seventh edition of the American Joint Committee on Cancer TNM staging system for gastric cancer

Cancer ◽  
2011 ◽  
Vol 117 (11) ◽  
pp. 2371-2378 ◽  
Author(s):  
Hun Jung ◽  
Han Hong Lee ◽  
Kyo Young Song ◽  
Hae Myung Jeon ◽  
Cho Hyun Park
Keyword(s):  
Gastric Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Seventh Edition ◽  
American Joint Committee ◽  
Tnm Staging System

scholarly journals Comparison of a Tumor-Ratio–Metastasis Staging System and the 8th AJCC TNM Staging System for Gastric Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Miaoquan Zhang ◽  
Chao Ding ◽  
Lin Xu ◽  
Biyi Ou ◽  
Shoucheng Feng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Likelihood Ratio ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Migration ◽  
Training Set ◽  
Discriminatory Ability ◽  
Tnm Staging System ◽  
Staging Systems ◽  
Validation Set

BackgroundDespite the implementation of the 8th American Joint Committee on Cancer (AJCC) TNM staging system for gastric cancer (GC) in 2017, it still holds a significant level of stage migration which affects patients’ proper classification and accurate prognosis. Here, to reduce this effect, we evaluated the prognostic value of a lymph node ratio (LNR) and established a novel tumor–ratio–metastasis (TRM) staging system.MethodThe data of 15,206 GC patients from the Sun Yat-sen University Cancer Center (Training set; n=2,032) and the US Surveillance, Epidemiology, and End Results (SEER) database (Validation set; n=13,174) were analyzed. The training set was classified into 5 LNR categories, based on which the novel TRM staging system was constructed. The overall survival (OS) between the TRM and AJCC TNM systems was compared in the training set and validated in the validation set. The likelihood ratio x2, liner trend x2, C-index, and Akaike information criterion (AIC) values were used to measure the discriminatory ability between the two different staging systems. Decision curve analyses (DCAs) were conducted to test the clinical value of the two staging systems.ResultThe patients were classified into the following categories: LNR0: 0%, LNR1: 0%&lt;LNR ≤ 10%, LNR2: 10%&lt;LNR ≤ 25%, LNR 3a: 25%&lt;LNR ≤ 60%, and LNR 3b: LNR&gt;60%. Univariate analyses demonstrated that the log-rank x2 of the LNR stage (Training/Validation set: x2 = 463.1/2880.8) was larger than the AJCC pN stage (Training/Validation set: x2 = 281.5/2240.8). For both the training set and validation set, stratified analyses using the Kaplan-Meier method identified significantly heterogeneous OS in every pN category but only one using the LNR. The TRM staging system had higher likelihood ratio x2, liner trend x2, C-index and smaller AIC values than the TNM system.ConclusionThe TRM staging system demonstrated improved homogeneity and discriminatory ability in predicting the prognosis of GC patients compared with the AJCC TNM staging system.

RA09.08: EVALUATION OF THE EIGHTH YPTNM CLASSIFICATION SYSTEM IN ESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 41-42
Author(s):  
Motoo Nomura ◽  
Shigeru Tsunoda ◽  
Katsuyuki Sakanaka ◽  
Masashi Tamaoki ◽  
Yusuke Amanuma ◽  
...  
Keyword(s):  
Staging System ◽  
Tnm Staging ◽  
Prognostic Impact ◽  
Poor Prognostic Factor ◽  
Pathologic Stage ◽  
7Th Edition ◽  
Tnm Staging System ◽  
Staging Systems ◽  
Prognostic Group ◽  
8Th Edition

Abstract Background The 7th edition of the Union for International Cancer Control (UICC) TNM staging system is based on pathologic data from esophageal cancers treated by surgery alone. In the 8th edition of UICC-TNM staging system, there is no information available for treatment modality (surgery alone or neoadjuvant therapy [NAC] followed by surgery [NAC-S]), although clinical stage, neoadjuvant pathologic stage, and pathologic stage were analyzed and identified. The objective of this study was to evaluate the prognostic impact of the new staging system on esophageal squamous cell cancer (ESCC) patients treated by NAC-S. Methods Database of 140 consecutive ESCC patients in our hospital was retrospectively restaged in 7th and 8th UICC-TNM system. The prognostic impacts of pathologic stage after NAC according to the both staging systems were compared. Results The median follow-up period was 4.8 years (range 0.2–9.7), with 49 patients dead at the time of analysis. In 7th edition, the 3-year overall survival rates (3y-OS) of ypStages 0, I, II, III, and IV were 100%, 93.5%, 93.5%, 43.9%, and 0.0%, respectively. In 8th edition, the 3y-OS of ypStages 0, I, II, III, and IV were 100%, 96.5%, 90.2%, 51.7%, and 29.6%, respectively. There were no marked differences between 7th and 8th edition in the prognoses. The both editions poorly distinguish the prognoses of ypStages 0, I, and II. For pathological prognostic group in 7th edition, the 3y-OS of Groups 0, I, II, III, and IV were 100%, 97.0%, 90.6%, 43.9%, and 0.0%, respectively. For pathological prognostic group in 8th edition, the 3y-OS of Groups 0, I, II, III, and IV were 100%, 96.7%, 89.8%, 51.7%, and 29.6%, respectively. For patients with ypStages 0-II, pretreatment higher CEA was poor prognostic factor (HR 7.1, 95% confidence interval 1.9–25.9). Conclusion Our study indicates the problem that the ypStage in the 8th TNM staging system poorly distinguish the prognoses of ypStages 0, I, and II in patients undergoing NAC-S. Additional study is needed to evaluate the role of ypStage 0-II incorporation of new prognostic factors. Disclosure All authors have declared no conflicts of interest.

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