Comparison of the UICC/AJCC 1992 and 1997 pN categories for gastric cancer patients after surgery.
OBJECTIVE
UICC/AJCC 1997 classification changes pN category. We evaluated its prognostic impact.


METHODS
A total of 710 patients who underwent a > or = D2 gastrectomy were recruited. Among them, the data of 319 patients who had involved regional lymph nodes and no evidence of distant metastases were used for comparing the 1992 and 1997 pN categories.


RESULTS
For 1997 category, 201 patients (64%) were pN1, 75 (23.5%) pN2, and 43 (13.5%) pN3. For 1992 category, 143 patients (44.8%) were pN1, and 147(46.1%) pN2. 29 patients (9.1%) with lymph node metastasis to the hepatoduodenal ligament were distant metastasis. The 1997 pN category was a more powerful prognostic discriminant (relative risk: 2.086) than the 1992 category. Compared to the 1992 stage classification, the 1997 one had a skewed distribution of patients with marked shift of patients of stage IIIA (105-126 patients), IIIB (116-58 patients), and IV (100-122 patients). The survival difference between stage IIIA and IIIB for the 1997 stage classification is narrower than for 1992.


CONCLUSIONS
The 1997 pN category allows for estimation of prognosis superior to the 1992 category.
Department of Surgery, Veterans General Hospital-Taipei, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China. cwwu@vghtpe.gov.tw
C W
CW
Wu
M C
MC
Hsieh
S S
SS
Lo
K H
KH
Shen
W Y
WY
Lui
F K
FK
P'eng
D000230:Adenocarcinoma / Q000145:classification* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate