Evaluation of the seventh AJCC TNM staging system for gastric cancer: a meta-analysis of cohort studies.
The AJCC seventh edition TNM classification for gastric cancer was released in 2010 and included major revision. Large-volume gastric cancer centers have evaluated the prognostic significance of the new system and obtained paradoxical results. The authors performed a meta-analysis of these studies to evaluate the new classification. Fifteen eligible studies with 38,972 patients were included in the analysis. Hazard ratios (HRs) and associated 95 % confidence intervals were extracted from identified studies. The primary outcome was overall survival. The HRs for the seventh edition T classification and N classification were found to increase steadily and reasonably. The cumulative survival rates of the seventh edition subgroups of T classifications demonstrated obvious differences; meanwhile, the differences between subgroups of N classifications including N3a and N3b categories were also significant. The 5-year survival rates according to the seventh edition TNM staging system were 94.71 % (stage IA), 88.72 % (stage IB), 80.45 % (stage IIA), 67.24 % (stage IIB), 53.68 % (stage IIIA), 37.56 % (stage IIIB), and 21.26 % (stage IIIC), respectively. The results of this study indicate that the seventh edition of the TNM classification was considered valid, although further evaluation was needed for N3a and N3b categories.
Department of Gastroenterological Surgery, People's Hospital, Peking University, Beijing, 100044, People's Republic of China.
Jizhun
J
Zhang
Yangbing
Y
Zhou
Kewei
K
Jiang
Zhanlong
Z
Shen
Yingjiang
Y
Ye
Shan
S
Wang
D015331:Cohort Studies; D009367:Neoplasm Staging / Q000379:methods*; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States