Recent results in the surgical treatment of gastric cancer according to the Japanese and TNM classification.
BACKGROUND
Recent outcomes based on surgical long-term follow-up of patients with gastric cancer using current staging systems have not been fully evaluated.


METHODS
A total of 1357 patients with primary gastric carcinoma (911 males and 446 females, ranging in age from 20 to 87 years; average 59.1 years) who had undergone gastric resection between 1986 and 1996 were examined with respect to their clinicopathological features, surgical procedures and patient survival according to Japanese and UICC-TNM classifications.


RESULTS
The 5-year survival rate was 95.3% for stage Ia, 85.5% for stage Ib, 73.8% for stage II, 45.7% for stage IIIa, 20.9% for stage IIIb, 17.3% for stage IVa and 5.8% for stage IVb (8.8% for IVa and IVb) on the Japanese classification. By way of contrast, the 5-year survival rate was 95.6% for stage Ia, 85.0% for stage Ib, 72.1% for stage II, 49.3% for stage IIIa, 30.2% for stage IIIb and 12.0% for stage IV on the TNM classification.


CONCLUSIONS
Although minor problems are associated with both the Japanese and TNM classification systems, both appear to be clinically significant and appropriate independent predictors of prognosis. The findings of the present study provide important information for comparing results among different institutes and for introducing new clinical trials for gastric cancer at the beginning of the new century.
Kikuchi
S
S
Department of Surgery, School of Medicine, Kitasato University, Sagamihara-shi, Kanagawa, Japan.
Sakakibara
Y
Y
Sakuramoto
S
S
Kobayashi
N
N
Shimao
H
H
Mieno
H
H
Kato
Y
Y
Kadowaki
K
K
Hiki
Y
Y
Kakita
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome