title: The prognostic efficacy and improvements of the 7th edition Union for International Cancer Control tumor-node-metastasis classifications for Chinese patients with gastric cancer: Results based on a retrospective three-decade population study.
abstract: This study aimed to evaluate survival trends for patients with gastric cancer in northeast China in the most recent three decades and analyze the applicability of the UICC tumor-node-metastasis (TNM) classification 7th edition for Chinese patients with gastric cancer. A review of all inpatient and outpatient records of patients with gastric cancer was conducted in the first hospital of China Medical University and the Liaoning Cancer Hospital and Institute. All patients who met the inclusion criteria and were seen from January 1980 through December 2009 were included in the study. The primary outcome was 5-year survival, which was analyzed according to decade of diagnosis and TNM classifications. From 1980 through 2009, the 5-year survival rates for patients with gastric cancer (n=2414) increased from 39.1% to 57.3%. Decade of diagnosis was significantly associated with patient survival (p = 0.013), and the 5-year survival rate in the 2000s was remarkably higher than that in the 1980s and 1990s (p = 0.004 and 0.049, respectively). When classified according to the UICC TNM classification of gastric cancer 7th edition, the prognoses of stage IIIA and stage IIIB patients were not significantly different (p = 0.077). However, if stage T4b and stage N0 patients were classified as stage IIIA, the prognoses of stage IIIA and stage IIIB patients were significantly different (p < 0.001). Hence, there was a significant difference in survival during the three time periods in Northeast China. Classifying stage T4b and stage N0 patients as stage IIIA according to the 7th edition of UICC gastric cancer TNM classifications better stratified Chinese patients and predicted prognoses.
authors.affiliation: 1 Department of Internal Neurology, The Second Hospital of Dalian Medical University, Dalian, China.
authors.forename: Huizi
authors.initials: H
authors.lastname: Gu
authors.affiliation: 2 Department of Radiology, Dalian Hospital of Traditional Chinese Medicine, Dalian, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.affiliation: 3 Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Shenyang, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhu
authors.affiliation: 4 Breast Disease and Reconstruction Center, Breast Cancer Key Lab of Dalian, The Second Hospital of Dalian Medical University, Dalian, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 5 Liaoning Medical Device Test Institute, Shenyang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yu
authors.affiliation: 6 Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, China.
authors.forename: Dongxue
authors.initials: D
authors.lastname: Qin
authors.affiliation: 6 Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Yi
authors.affiliation: 6 Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: 7 Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Lu
mesh_terms: D044466:Asian People; D002681:China; D006801:Humans; D008207:Lymphatic Metastasis; D008499:Medical Records; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D016019:Survival Analysis
keywords: Chinese population; gastric cancer; tumor–node–metastasis staging