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 Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study

2019 ◽  
Vol 44 (1) ◽  
pp. 213-222
Author(s):  
Lin-Yong Zhao ◽  
Yong-Liang Zhao ◽  
Jun-Jiang Wang ◽  
Qi-Di Zhao ◽  
Wen-Qi Yi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Plasma Fibrinogen ◽  
Tnm Staging System ◽  
N Stage ◽  
Gastric Cancer Patients

Abstract Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

A western validation of a novel gastric cancer prognostic model using American data.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 2-2
Author(s):  
Bryan S. Goldner ◽  
Ki Jun Song ◽  
Taeil Son ◽  
Hyoung-Il Kim ◽  
Laleh Melstrom ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Prediction Model ◽  
Cancer Patients ◽  
Staging System ◽  
Tnm Staging ◽  
Prediction Tool ◽  
C Statistic ◽  
Tnm Staging System ◽  
Gastric Cancer Patients

2 Background: A novel prediction model, the Yonsei University Gastric Cancer Prediction Tool was developed by an international collaborative group (G6+) for accurate determination of 5-year overall survival of gastric cancer patients. This prediction model was created using a prospectively maintained single institution database of 12,399 patients and included clinically relevant factors not accounted for in the TNM staging system. This prediction model was validated using external data sets from Asia; its’ applicability in the American population has yet to be determined through a validated data set. Methods: Using the SEER dataset, 2014 release, all patients with gastric adenocarcinoma diagnosed between the years 2002 –2012 who underwent resection were selected. The following characteristics were selected for analysis: age, sex, gender, depth of tumor invasion, number of positive lymph nodes, total lymph nodes retrieved, presence of distant metastasis, extent of resection, and histology. These data were processed through a recently published prognostic nomogram to obtain concordance index (C-statistic) using the bootstrap method and calibration was assessed. This was compared to the current prognostic index, the TNM staging system. Results: A total of 26,019 possible patients were identified from the SEER database, years 2002-2012. Of these, 11,765 had complete datasets. Validation of the prognostication model revealed a C-statistic of 0.762 (95% CI 0.754-0.769). This is compared to the 7thTNM staging model, C-statistic 0.683 (95% CI 0.677-0.689). The new nomogram was found to be significantly more accurate with a p-value of < 0.001. Conclusions: Our study validates a novel prediction model for gastric cancer in the American patient population. Using this model, superior accuracy in prognosticating the 5-year survival of gastric cancer patients was confirmed in the western cohort strongly supporting its global applicability. This model also allows for inclusion of those who did not undergo adequate lymphadenectomy or who underwent a non-curative resection and can be a useful prediction tool for an increasing number of gastric cancer patients world-wide.

scholarly journals Evaluation of the American Joint Committee on Cancer 8th edition staging system for gastric cancer patients after preoperative therapy

2017 ◽  
Vol 21 (1) ◽  
pp. 74-83 ◽  
Author(s):  
Naruhiko Ikoma ◽  
Mariela Blum ◽  
Jeannelyn S. Estrella ◽  
Prajnan Das ◽  
Wayne L. Hofstetter ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Staging System ◽  
Preoperative Therapy ◽  
American Joint Committee ◽  
Gastric Cancer Patients ◽  
8Th Edition

Is the AJCC TNM staging system still appropriate for gastric cancer patients survival after 5 years?

2019 ◽  
Vol 45 (6) ◽  
pp. 1115-1120
Author(s):  
Jian-Xian Lin ◽  
Jun-Peng Lin ◽  
Jian-Wei Xie ◽  
Jia-Bin Wang ◽  
Jun Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System ◽  
Gastric Cancer Patients
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