Appraisal of compliance with the UICC/AJCC staging system in the staging of gastric cancer. Union Internacional Contra la Cancrum/American Joint Committee on Cancer.
BACKGROUND
In the surgical management of gastric carcinoma, regional lymphatic spread is of prognostic importance. The fifth edition of the Union Internacional Contra la Cancrum classification has been shown to be reproducible, practical and of significant prognostic use. The tumour node metastasis (TNM) system requires at least 15 lymph nodes to be acquired and examined for staging to be accurate. This has raised concern over the consistency with which the requisite numbers of nodes would be acquired. This study was performed to assess how consistently surgically managed cases of gastric cancer in the West Midlands fulfilled this requirement to allow accurate staging.


METHODS
Data from the West Midlands Cancer Intelligence Unit on all cases of gastric cancer registered from 1998 to 1999 were obtained and the number of lymph nodes documented for each surgically managed case was assessed.


RESULTS
Overall, only 31.0 per cent of surgically resected cases could be assessed accurately according to the TNM system. The proportion staged accurately varied widely across hospitals from 10.9 to 76.0 per cent.


CONCLUSIONS
These results reflect the need for improved N staging across the region to aid the appropriate multimodal treatment of patients.
Mullaney
P J
PJ
Department of General Surgery, University Hospital Birmingham NHS Trust, Edgbaston, UK. pmullaney@yahoo.com
Wadley
M S
MS
Hyde
C
C
Wyatt
J
J
Lawrence
G
G
Hallissey
M T
MT
Fielding
J W L
JW
D019983:Guideline Adherence; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery