title: Incorporation of N0 Stage with Insufficient Numbers of Lymph Nodes into N1 Stage in the Seventh Edition of the TNM Classification Improves Prediction of Prognosis in Gastric Cancer: Results of a Single-Institution Study of 1258 Chinese Patients.
abstract: OBJECTIVE
  This study examined the prognosis of the "node-negative with eLNs ≤ 15" designation and the additional value of incorporating it into the pN1 designation in the seventh edition of the N classification.
  
  
  METHODS
  From January 2000 to September 2010, a total of 1258 gastric cancer patients (patients with eLNs > 15 or node-negative with eLNs ≤ 15) undergoing radical gastric resection were enrolled in this study. We incorporated node-negative patients with eLNs ≤ 15 into pN1 and compared this designation with the current 7th edition UICC N stage for 3, 5-year overall survival by univariate and multivariate analysis. Homogeneity, discriminatory ability, and monotonicity of gradients in the hypothetical N stage and the UICC N stage were compared using linear trend χ2, likelihood ratio χ2 statistics, and Akaike information criterion (AIC) calculations.
  
  
  RESULTS
  Node-negative patients with eLNs ≤ 15 had worse survival compared with those with eLNs > 15. In univariate and multivariate analyses, the hypothetical N stage showed superiority to the 7th edition pN staging. The hypothetical staging system had higher linear trend and likelihood ratio χ (2) scores and smaller AIC values compared with those for the TNM system, which represented the optimum prognostic stratification.
  
  
  CONCLUSIONS
  Node-negative patients with eLNs ≤ 15 can be considered to be incorporated into the pN1 stage in the 7th edition of the TNM classification.
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Bofei
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yuanfang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Qiu
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Sharvesh Raj
authors.initials: SR
authors.lastname: Seeruttun
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yongming
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yuanxiang
authors.initials: Y
authors.lastname: Guan
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Youqing
authors.initials: Y
authors.lastname: Zhan
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. zhouzhw@sysucc.org.cn.|State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China. zhouzhw@sysucc.org.cn.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China. zhouzhw@sysucc.org.cn.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000592:standards*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult