Suitability of 7th UICC N Stage for Predicting the Overall Survival of Gastric Cancer Patients After Curative Resection in China

Deng, Jingyu; Liang, Han; Sun, Dan; Wang, Dianchang; Pan, Yi

doi:10.1245/s10434-010-0939-x

Cited by 91 publications

(72 citation statements)

References 31 publications

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“…In accordance with Deng et al, N2 and N3 patients in our study using the 6th edition system (equivalent to N3a and N3b in the 7th edition) had similar survival. 13 The studies mentioned above show that the 6th edition UICC N stage less accurately reflected patient prognosis. Therefore, our results indicated that identifying lymph node metastases and classifying patients as N3a and N3b are unnecessary.…”

Section: Discussionmentioning

confidence: 99%

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.

Wang

2011

JCO

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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.

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Section: Discussionmentioning

confidence: 99%

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.

Wang

2011

JCO

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“…Yang et al [28] also reported that the 7th UICC T and N stages were more evenly distributed than the 6th UICC T and N stages. Deng et al [9] reported the superiority of the 7th UICC N stage, based on the evidence of the significant difference of 5-year survival rate between N1 and N2 substages of the 7th UICC N stage and no significant prognostic difference between N2 and N3 substages of the 5th/6th UICC N stage. They argued N2 and N3 substages of the 5th/6th UICC N classification should be integrated into only one substage as N3 instead of N3a and N3b in the 7th UICC N classification.…”

Section: Discussionmentioning

confidence: 99%

“…The depth of primary tumor infiltration and number of metastatic lymph nodes (LNs) are known to be the most important prognostic factors of gastric cancer after curative surgery [3][4][5][6][7]. Especially the extent of LN metastasis is considered to be the most important independent prognostic factor [8,9]. There are two major classification systems used for gastric cancer staging: the Japanese Classification of Gastric Cancer (JCGC) and the Union Internationale Contra le Cancer (UICC)/TNM classification system.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of the new (7th) UICC N classification in the prognosis evaluation of gastric cancer patients: a comparative study between the 5th/6th and 7th UICC N classification

Chae

Lee

2011

Gastric Cancer

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Background The most important prognostic factor after curative surgery for gastric carcinoma is the presence of lymph node metastases. According to the 7th edition of the UICC TNM staging system for gastric cancer, N classification was categorized as N0 (no regional lymph node metastasis), N1 (1-2 regional lymph node metastases), N2 (3-6 regional lymph node metastases), and N3 (7 or more regional lymph node metastases). The purpose of this study was to evaluate the rationality of the new UICC/AJCC N classification in comparison with the 6th UICC classification. Methods From August 2002 to July 2006, 295 patients with gastric cancer underwent curative resection with D2 lymph node dissection by a single surgeon. We analyzed retrospectively the significant prognostic factors and identified the suitability of the 7th UICC N staging system. Results According to the 7th UICC N classification, the 5-year cumulative survival rates (5-YSR) of N0, N1, N2, N3a, and N3b were 89.7, 73.6, 54.9, 23.1, and 5.4%, respectively (P \ 0.0001). Using univariate analysis, the N classification of the 7th and 6th UICC/AJCC TNM staging system, T classification of the 7th UICC TNM staging system, size and location of tumor, and histology were associated with the overall survival of gastric cancer after curative surgery. However, Cox regression multivariate analysis showed the 7th UICC N classification was an independent prognostic factor instead of the 6th UICC N classification (P \ 0.0001). ConclusionThe 7th UICC classification for lymph node metastasis is thought to be a more reliable prognostic factor for gastric cancer than the 6th classification.

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“…Some researchers thought that it was not an independent prognostic factor [38][39][40], whereas others thought that younger patients has worse prognoses than elderly due to the worse biological behaviors of tumors and histological type [41]. However, Saito et al held that elderly patients had worse prognosis because they had limited lymph node dissection and lower tolerance of chemotherapy [42].…”

Section: Agementioning

confidence: 99%

Prognosis in the Cancer of the Stomach

Akturk¹,

Ulusoy²

2013

Gastric Carcinoma- New Insights Into Current Management

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Suitability of 7th UICC N Stage for Predicting the Overall Survival of Gastric Cancer Patients After Curative Resection in China

Abstract: The 7th UICC N stage appears to provide a reliable prognostic category of MLNC of gastric cancer than the 5th/6th UICC N stage, and it is the efficiently prognostic indicator of gastric cancer after curative surgery.

Cited by 91 publications

References 31 publications

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.

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.

The effectiveness of the new (7th) UICC N classification in the prognosis evaluation of gastric cancer patients: a comparative study between the 5th/6th and 7th UICC N classification

Prognosis in the Cancer of the Stomach

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