Seventh tumor-node-metastasis staging of gastric cancer: Five-year follow-up.
Seventh tumor-node-metastasis (TNM) classification for gastric cancer, published in 2010, introduced changes in all of its three parameters with the aim to increase its accuracy in prognostication. The aim of this review is to analyze the efficacy of these changes and their implication in clinical practice. We reviewed relevant Literature concerning staging systems in gastric cancer from 2010 up to March 2016. Adenocarcinoma of the esophago-gastric junction still remains a debated entity, due to its peculiar anatomical and histological situation: further improvement in its staging are required. Concerning distant metastases, positive peritoneal cytology has been adopted as a criterion to define metastatic disease: however, its search in clinical practice is still far from being routinely performed, as staging laparoscopy has not yet reached wide diffusion. Regarding definition of T and N: in the era of multimodal treatment these parameters should more influence both staging and surgery. The changes about T-staging suggested some modifications in clinical practice. Differently, many controversies on lymph node staging are still ongoing, with the proposal of alternative classification systems in order to minimize the extent of lymphadenectomy. The next TNM classification should take into account all of these aspects to improve its accuracy and the comparability of prognosis in patients from both Eastern and Western world.
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Stefano
S
Rausei
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Laura
L
Ruspi
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Federica
F
Galli
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Vincenzo
V
Pappalardo
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Giuseppe
G
Di Rocco
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Francesco
F
Martignoni
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Francesco
F
Frattini
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Francesca
F
Rovera
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Luigi
L
Boni
Stefano Rausei, Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Giuseppe Di Rocco, Francesco Martignoni, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, University of Insubria, 21100 Varese, Italy.
Gianlorenzo
G
Dionigi
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D004938:Esophageal Neoplasms / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging / Q000379:methods*; D010537:Peritoneum / Q000473:pathology; D011379:Prognosis; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology*
Clinical practice; Gastric cancer; Prognostic factors; Staging system; Tumor-node-metastasis
J Surg Oncol. 2005 Jun 1;90(3):139-46; discussion 146
15895452
N Engl J Med. 2006 Jul 6;355(1):11-20
16822992
J Clin Oncol. 2007 May 20;25(15):2107-16
17513817
Gan To Kagaku Ryoho. 2007 Jun;34(6):817-23
17565240
Ann Surg Oncol. 2009 Dec;16(12):3227-36
19777180
Surg Today. 2010;40(2):119-24
20107950
Cancer. 2010 Jun 1;116(11):2571-80
20336791
Ann Surg Oncol. 2010 Oct;17(10):2733-9
20490698
Cancer. 2010 Dec 15;116(24):5592-8
20737569
Mod Pathol. 2011 Jan;24(1):138-46
20852593
Ann Surg Oncol. 2011 May;18(5):1219-21
20878488
Gastric Cancer. 2011 Jun;14(2):166-71
21360132
Gastric Cancer. 2011 Jun;14(2):113-23
21573742
Am J Surg Pathol. 2011 Oct;35(10):1512-22
21934477
Endoscopy. 2012 Jan;44(1):74-94
22198778
Ann Surg. 2012 Mar;255(3):478-85
22330040
Ann Surg Oncol. 2012 Aug;19(8):2443-51
22618718
Gastric Cancer. 2013 Jul;16(3):309-17
22945599
Ann Surg Oncol. 2013 Mar;20(3):773-9
23224137
Acta Oncol. 2013 Nov;52(8):1751-9
23317142
Br J Surg. 2013 Mar;100(4):505-14
23319421
Ann Surg Oncol. 2013 Aug;20(8):2713-20
23456315
Am Surg. 2013 Mar;79(3):284-9
23461955
Am J Surg. 2014 Apr;207(4):555-65
24124661
J Gastrointest Surg. 2013 Dec;17(12):2059-66
24129828
Gastric Cancer. 2015 Jan;18(1):200-1
24682591
Surg Laparosc Endosc Percutan Tech. 2014 Oct;24(5):434-9
24910937
Eur J Cancer. 2015 Mar;51(5):577-86
25682192
Medicine (Baltimore). 2015 Feb;94(8):e575
25715257
Int J Clin Exp Pathol. 2015 Apr 01;8(4):3910-8
26097575
Scand J Surg. 2016 Jun;105(2):104-8
26261200
Medicine (Baltimore). 2015 Aug;94(34):e1386
26313779
Int J Clin Exp Med. 2015 Jul 15;8(7):10668-77
26379858
Gastric Cancer. 2017 Mar;20(2):217-225
26897166
Transl Gastroenterol Hepatol. 2016 Mar 16;1:10
28138577
Br J Surg. 1998 Nov;85(11):1457-9
9823902