Comparison of the Survival Difference Between AJCC 6th and 7th Editions for Gastric Cancer Patients
- 15 September 2011
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 35 (12), 2723-2729
- https://doi.org/10.1007/s00268-011-1275-4
Abstract
The AJCC 7th edition changes the classification of T- and N-factors and the TNM stage of gastric cancer. We evaluated its prognostic impact. From December 1987 to December 2006, a total of 1,380 patients underwent curative surgery for gastric cancer at the Department of Surgery, Taipei Veterans General Hospital, with a retrieved lymph node number ≥ 15. Survival was compared for disease classified according to the AJCC 6th and 7th editions. There is a significant difference in 5-year survival between T2 and T3 gastric cancer classified according to the AJCC 7th edition (75.2 vs. 54.9%, p < 0.001), as well as between N1 and N2 (71.4 vs. 44.1%, p < 0.001). Although patients with N3a had a better 5-year survival than did those with N3b (27.6 vs. 11.3%, p < 0.001), the N3 categories were combined and not applied in the TNM stage in the 7th edition. Multivariate analysis using Cox's proportional hazards model with a forward logistics regression stepwise procedure demonstrates that age, N category of 6th edition, and T and N categories of 7th edition are independent prognostic factors; however, T category of 6th edition is no longer significant. Furthermore, the discriminative power of survival difference between each TNM stage seems to be comparable between the 6th and 7th editions. The AJCC 7th edition provides a more stratified survival difference in staging of gastric cancer. Future division of N3a and N3b in the classification of the TNM stage is recommended.Keywords
Funding Information
- Taipei Veterans General Hospital (DOH100‐TD‐C‐111‐007)
This publication has 7 references indexed in Scilit:
- Evaluation of the Seventh American Joint Committee on Cancer/International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classificationCancer, 2010
- Suitability of 7th UICC N Stage for Predicting the Overall Survival of Gastric Cancer Patients After Curative Resection in ChinaAnnals of Surgical Oncology, 2010
- Prognostic value of subclassification of T2 tumours in patients with gastric cancerBritish Journal of Surgery, 2009
- Adjuvant Chemotherapy for Gastric Cancer with S-1, an Oral FluoropyrimidineNew England Journal of Medicine, 2007
- Subclassification of pT2 gastric adenocarcinoma according to depth of invasion (pT2a vs pT2b) and lymph node status (pN)Surgery, 2007
- Incidence and Factors Associated with Recurrence Patterns after Intended Curative Surgery for Gastric CancerWorld Journal of Surgery, 2003
- StomachPublished by Springer Science and Business Media LLC ,2002