A comparison between the seventh and sixth editions of the American Joint Committee on Cancer/International Union Against classification of gastric cancer.
OBJECTIVE
To evaluate the prognostic significance of the seventh edition TNM staging classification for gastric cancer.


BACKGROUND
The seventh edition TNM staging system for gastric cancer was adopted by the American Joint Committee on Cancer/International Union Against Cancer on January 1, 2010, and included major revisions.


METHODS
The authors analyzed data retrospectively collected on patients with gastric cancer who underwent surgery at the Affiliated Hospital of Qingdao University Medical College between 2000 and 2008. A total of 964 patients with gastric cancer who underwent R0 surgical resection were included.


RESULTS
The relative risk (RR) for the seventh edition T classification was found to increase steadily and reasonably compared with the sixth edition. However, the RR for the sixth edition N classification was found to increase steadily and reasonably compared with the seventh edition classification. Cox regression multivariate analysis showed that the sixth edition N classification was superior to the seventh edition N classification as an independent prognostic factor. In survival analysis, the seventh edition TNM classification provided a more detailed classification; however, some subgroups of the seventh edition TNM classification did not demonstrate significantly different survival rates. The combination of the seventh edition T classification and the sixth edition N classification, with ideal RR results, showed significantly different survival rates except for IA and IB.


CONCLUSIONS
The combination of the seventh edition T classification and the sixth edition N classification seems to provide the optimal prognosis.
Department of General Surgery, Affiliated Hospital to Medical College of Qingdao University, Qingdao, China.
Jizhun
J
Zhang
Zhaojian
Z
Niu
Yanbing
Y
Zhou
Shougen
S
Cao
D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents