Does the New UICC/AJCC TNM Staging System (7th Edition) Improve Assessing Prognosis in Gastric Cancer Compared to the Old System (6th Edition)?

2009 ◽  
Vol 9 (4) ◽  
pp. 159 ◽  
Author(s):  
Tae Kyung Ha ◽  
Hyun Ja Kim ◽  
Sung Joon Kwon
Keyword(s):  
Gastric Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
7Th Edition ◽  
Tnm Staging System

scholarly journals Prognostic Discrepancy of the 6th and 7th UICC N Classification for Lymph Node Staging in Gastric Cancer Patients after Curative Resection

2017 ◽  
Vol 10 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Sung Jin Oh ◽  
Byoung Jo Suh ◽  
Jong Kwon Park ◽  
Sung Don Oh ◽  
Hang Jong Yu
Keyword(s):  
Gastric Cancer ◽  
Curative Resection ◽  
Staging System ◽  
Tnm Staging ◽  
7Th Edition ◽  
Kaplan Meier ◽  
Tnm Staging System ◽  
N Classification ◽  
N Stage ◽  
Uicc Staging System

Background: The validity of N classification of the 7th edition of the American Joint Committee on Cancer/Union Internationale contre le Cancer (AJCC/UICC) tumor-node-metastasis (TNM) staging system is still under debate. The purpose of this study was to evaluate the prognostic efficacy of the 7th edition of the AJCC/UICC TNM staging system (focusing on N stage), in comparison with the 6th edition, at a single Eastern institution. Methods: We analyzed 1,435 patients with gastric cancer who underwent curative resection performed from September 1998 to August 2003 at the Memorial Jin-Pok Kim Korea Gastric Cancer Center. We analyzed the survival rate of the patients according to the AJCC/UICC 6th and 7th editions, and compared each stage, focusing on N stage. Results: Significant differences in the 5-year survival rates were observed between the 6th and the 7th AJCC/UICC staging system. In the 6th edition staging system, the Kaplan-Meier curves discriminated each N stage significantly. In contrast, there was no difference in terms of survival curves for N stage according to the 7th edition, especially between N1 and N2: the Kaplan-Meier plots of survival curves between N1 (77.0%) and N2 (78.1%) stages overlapped significantly (p < 0.05). Conclusion: Although the 7th UICC staging system is a more detailed and sophisticated system in the T category, there was no prognostic significance between the pN1 and pN2 stages according to our data. Therefore, we suggest establishing a new UICC staging system taking into consideration the application of the N stage.

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.

Evaluation of the seventh AJCC TNM staging system for gastric cancer: a meta-analysis of cohort studies

Tumor Biology ◽  
2014 ◽  
Vol 35 (9) ◽  
pp. 8525-8532 ◽  
Author(s):  
Jizhun Zhang ◽  
Yangbing Zhou ◽  
Kewei Jiang ◽  
Zhanlong Shen ◽  
Yingjiang Ye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System

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.

scholarly journals A nomogram based on Aspartate Aminotransferase/Alanine Aminotransferase (AST/ALT) ratio after surgery to predict the prognostic value in patients with gastric cancer

2020 ◽  
Author(s):  
Linfang Li ◽  
Shan Xing ◽  
Ning Xue ◽  
Miantao Wu ◽  
Yaqing Liang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Cox Regression ◽  
Staging System ◽  
Tnm Staging ◽  
Calibration Plot ◽  
Study Cohort ◽  
Tnm Staging System ◽  
Resectable Gastric Cancer

Abstract Background This study aimed to develop an effective nomogram for predicting overall survival (OS) in surgically treated gastric cancer. Methods We retrospectively evaluated 190 gastric cancer in this study. Cox regression analyses were performed to identify significant prognostic factors for OS in patients with resectable gastric cancer. The predictive accuracy of nomogram was assessed by calibration plot, concordance index (C-index) and decision curve, and then were compared with the traditional TNM staging system. Based on the total points (TPS) by nomogram, we further divided patients into different risk groups. Results On multivariate analysis of the 190 cohort, independent factors for survival were age, clinical stage and Aspartate Aminotransferase/Alanine Aminotransferase (SLR), which were entered into the nomogram. The calibration curve for the probability of OS showed that the nomogram-based predictions were in good agreement with actual observations. And the C-index of the established nomogram for predicting OS had a superior discrimination power compared with the TNM staging system [0.768 (95% CI: 0.725-0.810) vs 0.730 (95% CI: 0.688-0.772), p < 0.05]. Decision curve also demonstrated that the nomogram was better than TNM staging system. Based on the TPS of the nomogram, we further subdivided the study cohort into 3 groups: low risk (TPS ≤ 158), middle risk (158 < TPS ≤ 188), high risk (TPS > 188), the differences of OS rate were significant in the groups. Conclusions The established nomogram resulted in more accurate prognostic prediction for individual patient with resectable gastric cancer.

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