Comparison of five systems for staging lymph node metastasis in gastric cancer.
BACKGROUND
There are several systems for staging lymph node metastasis in gastric cancer. Their relative merits are not clear.


METHODS
In this retrospective analysis, the nodal status was classified according to the Union Internacional Contra la Cancrum (UICC) and Japanese staging systems, the number and frequency of lymph node metastasis, and the level of involved nodes. Each staging system was scored as good (+1), fair (0) or poor (-1) with respect to prognostic value, theoretical value, convenience, reproducibility and surgical applicability.


RESULTS
There were no differences between the five staging systems in predicting survival. The Japanese staging system was most arbitrary owing to the complexity of the system, although it had an advantage in surgical application. The same disadvantage was found in the UICC system and the level system. Determination of the number and frequency of involved nodes was convenient and reproducible, but the number of lymph nodes dissected must be considered when the number of positive nodes is used for staging.


CONCLUSIONS
The classification of metastasis to the regional lymph nodes as N0 (no nodal metastasis), N1 (metastasis in 1-25 per cent of dissected nodes) and N2 (metastasis in more than 25 per cent of dissected nodes) would be a simple, convenient, reproducible staging system with an ability to predict surgical results.
Yu
W
W
Department of Surgery, Kyungpook National University Hospital, Taegu, Korea.
Choi
G S
GS
Whang
I
I
Suh
I S
IS
D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors