scholarly journals Comparison of the current AJCC-TNM numeric-based with a new anatomical location-based lymph node staging system for gastric cancer: A western experience

PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0173619 ◽  
Author(s):  
Gennaro Galizia ◽  
Eva Lieto ◽  
Annamaria Auricchio ◽  
Francesca Cardella ◽  
Andrea Mabilia ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Anatomical Location ◽  
Western Experience

Comparison of lymph node staging system in gastric cancer using time-dependent ROC analysis with Harrell’s concordance index.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 12-12
Author(s):  
Etsuro Bando ◽  
Norihiko Sugisawa ◽  
Masanori Tokunaga ◽  
Yutaka Tanizawa ◽  
Taiichi Kawamura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Survival Rate ◽  
Roc Analysis ◽  
Staging System ◽  
Time Dependent ◽  
Lymph Node Staging ◽  
Anatomical Location ◽  
Node Negative ◽  
Staging Systems

12 Background: The aim this study was to clarify what the most informative pathologic lymph node staging system in gastric cancer is, by using time-dependent receiver operating characteristic (ROC) analysis with Harrell’s concordance (c) index. Methods: This study enrolled 2747 primary gastric cancer patients, without prior chemotherapy, who underwent R0 or R1 macroscopically curative resection. We calculated concordance indices of different 3 nodal staging systems (anatomical level based on JPN 13th edition vs. numbers of metastatic nodes based upon TNM 7th edition vs. ratio of metastatic nodes; derived from Yu’s definition {Yu et al. Br J Surg;1997,N0:0, N1;0-0.1, N2;0.1-0.25, N3;0.25-}) for survival. Results: (Anatomical level) Harrell’s c-index was 0.754 with 5-year survival rate of N0; 93%, N1; 73%, N2; 51%, N3; 19%. C-index without node-negative patients was 0.628. (Numbers of positive nodes) C-index was 0.767 with 5-year survival rate of N0; 93%, N1; 81%, N2; 68%, N3; 37%. C-index without node-negative patients was 0.669. (Ratio of nodal involvement) C-index was 0.770 with 5-year survival rate of N0; 93%, N1; 80%, N2; 63%, N3; 29%. C-index without node-negative patients was 0.691, which is significantly larger than those in anatomical level or numbers of positive nodes (p<0.001, p=0.014, respectively). (Comparison of Staging System) If combined pT category with ratio grading system without pStage IA, new staging system is the significantly most informative (c-index; 0.760) than JPN 13th (c-index; 0.735) or TNM 7th (c-index; 0.742) (p=0.009, p=0.023, respectively). Conclusions: Lymph node staging system based on the conception of ratio of metastatic nodes is the most informative staging system than those with anatomical location or numbers of metastatic nodes. These results suggested that in gastric cancer pathologic staging system in next TNM classification should include the ratio of metastatic nodes.

Proposal of a new lymph node staging system for gastric cancer: study from two institutions in China

2014 ◽  
Vol 31 (10) ◽  
Author(s):  
Jizhun Zhang ◽  
Kewei Jiang ◽  
Yong Liu ◽  
Yingjiang Ye ◽  
Liang Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Cancer Study ◽  
Gastric Cancer Study

A novel simplified approach to incorporating lymph node ratio into gastric cancer staging.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 24-24
Author(s):  
Sarah B. Fisher ◽  
Malcolm Hart Squires ◽  
Sameer H. Patel ◽  
David A. Kooby ◽  
Kenneth Cardona ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Staging System ◽  
Cancer Staging ◽  
Lymph Node Staging ◽  
Cox Regression Analysis ◽  
Simplified Approach ◽  
Staging Systems ◽  
Node Ratio

24 Background: Previous investigators have reported on the value of lymph node ratio (LNR, defined as the number of positive nodes divided by the total number of nodes assessed) in gastric adenocarcinoma (GAC) staging. Given the complexity of previously proposed staging systems, it has not gained widespread acceptance. The aim of our study was to offer a novel simplified approach to incorporating LNR into gastric cancer staging. Methods: 131 patients who underwent curative intent resection with lymphadenectomy for GAC between 1/00-6/11 were identified. Clinicopathologic factors were assessed. Primary outcome was overall survival (OS). Results: Median age was 64 yrs, 51% were male. Median tumor size was 3.5 cm, 67% were poorly differentiated, 20% had perineural invasion, 31% had lymphovascular invasion, and 6% had a positive margin. Locoregional nodal metastases were present in 59% (n=77, N0: 41%, N1: 18%, N2: 22%, N3a: 14%, N3b: 5%). Median number of lymph nodes (LN) assessed was 15.5. Mean FU was 27.3 mos, median OS was 29.3 mos. Median LNR was 0.4 (.04-1). Patients with LNR ≥0.4 had decreased OS as compared to patients with LNR <0.4 (15.1 vs 41.5 mos, p<0.0001); the survival of patients with LNR <0.4 was similar to that of node negative pts (48 mos, p=0.882). On Cox regression analysis, LNR ≥0.4 was more strongly associated with decreased OS (HR 3.09, 95%CI: 1.81-5.26; p<0.0001) compared to the AJCC 7th edition N stage (HR 1.36, 95%CI: 1.11-1.68; p=0.004). In the subset of patients who were inadequately staged and had <16 nodes examined, a LNR ≥0.4 was associated with reduced survival compared to a LNR <0.4 (17.3 vs 41.5 mos, p=.04). Conclusions: Compared to the current lymph node staging system, a lymph node ratio using 0.4 as the cutoff may more accurately predict survival outcomes. It seems to be particularly useful in patients who have inadequate nodal assessment. This simplified approach to lymph node ratio may be a more valuable staging tool than the current AJCC nodal staging system for gastric cancer and needs to be validated.

scholarly journals A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems

PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0149555 ◽  
Author(s):  
Yoon Young Choi ◽  
Ji Yeong An ◽  
Hitoshi Katai ◽  
Yasuyuki Seto ◽  
Takeo Fukagawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Hybrid Type

Topographic lymph node staging system shows prognostic superiority compared to the 8th edition of AJCC TNM in gastric cancer. A western monocentric experience

2020 ◽  
Vol 34 ◽  
pp. 223-233
Author(s):  
S. Lauricella ◽  
M. Caricato ◽  
G. Mascianà ◽  
F. Carannante ◽  
M. Carnazza ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
8Th Edition

Hybrid Topographic Lymph Node Staging System Shows Prognostic Superiority to Numeric Pathologic Lymph Node Classification in Gastric Cancer

2019 ◽  
Vol 229 (4) ◽  
pp. e54
Author(s):  
Gabriella T. Capolupo ◽  
Sara Lauricella ◽  
Gianluca Mascianà ◽  
Erica Mazzotta ◽  
Filippo Carannante ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Node Classification ◽  
Pathologic Lymph Node

Impact of anatomical location of positive lymph node on TNM classification in patients with node positive gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 155-155
Author(s):  
Masanori Tokunaga ◽  
Makoto Hikage ◽  
Rie Makuuchi ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Tnm Classification ◽  
Staging System ◽  
Positive Lymph Node ◽  
Survival Outcome ◽  
Anatomical Location ◽  
Nodal Staging ◽  
Node Positive ◽  
7Th Edition

155 Background: In the 7th edition of TNM classification, node positive gastric cancer is subclassified into three categories (N1, 1-2 positive nodes; N2, 3-6 positive nodes; N3, 7 or more positive nodes) according to the number of positive lymph node (LN). However, anatomical location of positive LN is not taken into account in the TNM classification, although Japanese classification for gastric cancer had adopted anatomical location oriented nodal staging system and had shown relevance between location of positive LN and survival outcome. The aim of the present study is, therefore, to clarify the impact of anatomical location of positive LN on numerical number oriented, latest TNM nodal staging system. Methods: The present study included 1047 node positive gastric cancer patients who underwent curative gastrectomy at the Shizuoka Cancer Center between September 2002 and December 2014. Survival outcomes were compared between patients with positive extra-perigastric lymph node (PEPLN) and those with positive perigastric lymph node (PPLN) in each nodal stage according to the 7th edition of TNM classification. Results: The present study included 471 N1 patients, 309 N2 patients, and 267 N3 according to the 7th edition of TNM classification, and 5-year survival rates (5ysr) were 81.8%, 70.5%, and 51.9%, respectively. In the N1 group, 5ysr was 75.4% in patients with PEPLN, while it was 83.2% in those with PPLN, and the difference was not statistically significant (P = 0.105). It was also similar between patients with PEPLN (64.2%) and those with PPLN (73.8%, P = 0.343) in the N2 group. However, in the N3 group, survival outcome was significantly worse in patients with PEPLN (47.9%) than in those with PPLN (63.9%, P = 0.036). Conclusions: In the N1 and N2 group, involvement of extraperigastric LN did not have impact on survival outcome. On the contrary, in the N3 group, patients with PEPLN showed worse survival outcome than those with PPLN, and they could be potential candidates for intense postoperative adjuvant treatment.

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