Comparison of the 6th and 7th editions of the UICC TNM staging system for gastric cancer: Results of a Chinese single-institution study of 1,503 patients.

Abstract

Aim. To evaluate the prognostic efficacy of the 7th edition tumor-node-metastasis (TNM) classification compared with the 6th edition in gastric cancer patients. Methods. A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend v 2 , likelihood ratio v 2 statistics, and Akaike information criterion (AIC) calculations.Results. Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio v 2 scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.Conclusions. Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.Gastric cancer is the fourth most common malignant tumor in the world, with an estimated 1 million new cases every year.1 More new cases of gastric cancer are diagnosed in China each year than in any other country.

Validity and Necessity of Sub-classification of N3 in the 7thUICC TNM Stage of Gastric Cancer

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Clinical significance of NOTCH1 intracellular cytoplasmic domain translocation into the nucleus in gastric cancer

“…All samples were snap-frozen in liquid nitrogen and stored at -80˚C. The tumors were classified according to 6 th UICC guidelines for clinical and pathological studies on gastric cancer (8). Written, informed consent was obtained from each patient and approval was obtained from the ethical committee on human research of Nagoya City University (code, no.…”

External Validation of the Proposed Kiel Staging System and Comparison with the Old (6th Edition) and the Currently Used (7th Edition) TNM Classification in Gastric Cancer

“…Conclusions: The Kiel staging system for gastric so-called Siewert I-III EGJ tumors [5]) were staged as esophageal cancer; (2) pT categories were modified to correspond to those of esophageal and colon cancers; (3) pN categories were modified with pN1 = 1-2 positive nodes (compared to 1-6 in the 2002 criteria); pN2 = 3-6 positive nodes (compared to 7-15 in 2002), and pN3 = 7 or more positive nodes (compared to > 15 in 2002); and (4) the number of stages increased from 6 to 8. According to numerous studies [6][7][8][9][10], this increase in stages of the 7th edition enhanced the prognostic stratification in patients with gastric cancer.…”