A comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage in gastric carcinoma.
OBJECTIVE
To clarify what staging system of lymph node metastasis is suitable for evaluating prognosis of gastric cancer patients.


METHODS
We analyzed the survival 5 years after operation of 186 advanced gastric cancer patients who underwent potentially curative gastric resection. The following 3 systems were compared using multivariate analyses by the logistic regression model. Nodal status in pathology was classified as follows: (a) nodal stage according to the General Rules for the Gastric Cancer Study of the Japanese Research Society for Gastric Cancer (the Japanese Rules), (b) number of metastatic nodes according to the new UICC staging system (the TNM system), (c) number of metastatic nodes in n1 group of the Japanese Rules (the new classification).


RESULTS
The TNM system revealed better results than the nodal stage in sensitivity and -2 log likelihood. The new classification revealed the best result among the 3 systems in sensitivity, specificity, accuracy and -2 log likelihood.


CONCLUSIONS
The TNM system is a better prognostic factor than the nodal stage in the Japanese Rules, and the new classification is the best prognostic factor of the above 3 systems in potentially curative advanced gastric cancer patients. Furthermore, the new classification might be useful in comparing data between some facilities.
Kato
M
M
Second Department of Surgery, Gifu University School of Medicine, Japan. motohisa@cc.gifu-u.ac.jp
Saji
S
S
Kawaguchi
Y
Y
Kunieda
K
K
Sugiyama
Y
Y
Takagi
Y
Y
Hiraoka
T
T
Kumazawa
I
I
Adachi
T
T
D000230:Adenocarcinoma / Q000145:classification / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016013:Likelihood Functions; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate