The 8th edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for gastric cancer is superior to the 7th edition: results from a Chinese mono-institutional study of 1663 patients
Background We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer. Methods The survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed. Results In the 8th edition system, homogen...
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| Published in | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 21; no. 4; pp. 643 - 652 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Tokyo
Springer Japan
01.07.2018
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1436-3291 1436-3305 1436-3305 |
| DOI | 10.1007/s10120-017-0779-5 |
Cover
| Abstract | Background
We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.
Methods
The survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed.
Results
In the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (
P
= 0.010), IIIB (
P
= 0.004), and IIIC (
P
< 0.001). For patients in the pT1-3 (
P
< 0.001) and pT4a (
P
< 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value.
Conclusions
The 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer. |
|---|---|
| AbstractList | Background
We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.
Methods
The survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed.
Results
In the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (
P
= 0.010), IIIB (
P
= 0.004), and IIIC (
P
< 0.001). For patients in the pT1-3 (
P
< 0.001) and pT4a (
P
< 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value.
Conclusions
The 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer. BackgroundWe investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.MethodsThe survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed.ResultsIn the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (P = 0.010), IIIB (P = 0.004), and IIIC (P < 0.001). For patients in the pT1-3 (P < 0.001) and pT4a (P < 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value.ConclusionsThe 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer. We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer. The survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed. In the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (P = 0.010), IIIB (P = 0.004), and IIIC (P < 0.001). For patients in the pT1-3 (P < 0.001) and pT4a (P < 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value. The 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer. We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.BACKGROUNDWe investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.The survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed.METHODSThe survival outcomes of 1663 patients with gastric cancer undergoing radical resection were analyzed.In the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (P = 0.010), IIIB (P = 0.004), and IIIC (P < 0.001). For patients in the pT1-3 (P < 0.001) and pT4a (P < 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value.RESULTSIn the 8th edition system, homogeneous 5-year survival rates among different pathological TNM (pTNM) categories belonging to the same stage were observed. However, in the 7th edition system, the differences of 5-year survival rate among pTNM categories belonging to the same stage were observed in stages IIB (P = 0.010), IIIB (P = 0.004), and IIIC (P < 0.001). For patients in the pT1-3 (P < 0.001) and pT4a (P < 0.001) categories, there were significant differences in survival between patients in the pN3a and pN3b categories. Furthermore, partial cases (pT4bN0M0/T4aN2M0) of stage IIIB were downstaged to stage IIIA in the 8th edition system, and the 5-year survival rate of these patients was significantly better than that of patients in stage IIIB in the 8th edition system. Similarly, the 5-year survival rate of patients in p4bN2M0/T4aN3aM0 downstaged from stage IIIC to IIIB was significantly better than that of patients in stage IIIC. Compared with the 7th edition system, the 8th edition system had a higher likelihood ratio and linear trend chi-squared score and a smaller Akaike information criteria value.The 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer.CONCLUSIONSThe 8th edition system is superior to the 7th edition system in terms of homogeneity, discriminatory ability, and monotonicity of gradients for Chinese patients with gastric cancer. |
| Author | Shan, Fei Zhang, Ji Bu, Zhao-De Ji, Jia-Fu Wu, Ai-Wen Jia, Zi-Yu Li, Shuang-Xi Li, Zi-Yu Zhang, Lian-Hai Yan, Yan Wu, Xiao-Jiang Zong, Xiang-Long Ji, Xin |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29168120$$D View this record in MEDLINE/PubMed |
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| Copyright | The Author(s) 2017 Gastric Cancer is a copyright of Springer, (2017). All Rights Reserved. |
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| PublicationDate_xml | – month: 07 year: 2018 text: 2018-07-01 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | Tokyo |
| PublicationPlace_xml | – name: Tokyo – name: Japan |
| PublicationTitle | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association |
| PublicationTitleAbbrev | Gastric Cancer |
| PublicationTitleAlternate | Gastric Cancer |
| PublicationYear | 2018 |
| Publisher | Springer Japan Springer Nature B.V |
| Publisher_xml | – name: Springer Japan – name: Springer Nature B.V |
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| References_xml | – volume: 14 start-page: 113 issue: 2 year: 2011 end-page: 123 ident: CR16 article-title: Japanese gastric cancer treatment guidelines 2010 (ver. 3) publication-title: Gastric Cancer doi: 10.1007/s10120-011-0042-4 – volume: 19 start-page: 1918 issue: 6 year: 2012 end-page: 1927 ident: CR10 article-title: Evaluation of the seventh edition of American Joint Committee on Cancer TNM staging system for gastric cancer: results from a Chinese monoinstitutional study publication-title: Ann Surg Oncol doi: 10.1245/s10434-011-2206-1 – year: 2017 ident: CR14 publication-title: AJCC cancer staging manual doi: 10.1007/978-3-319-40618-3 – volume: 136 start-page: E359 issue: 5 year: 2015 end-page: E386 ident: CR2 article-title: Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 publication-title: Int J Cancer doi: 10.1002/ijc.29210 – volume: 103 start-page: 1835 issue: 7 year: 2008 end-page: 1836 ident: CR20 article-title: Comparison of seven staging systems in cirrhotic patients with hepatocellular carcinoma in a cohort of patients who underwent radiofrequency ablation with complete response publication-title: Am J Gastroenterol doi: 10.1111/j.1572-0241.2008.01959_3.x – volume: 35 start-page: 2723 issue: 12 year: 2011 end-page: 2729 ident: CR8 article-title: Comparison of the survival difference between AJCC 6th and 7th editions for gastric cancer patients publication-title: World J Surg doi: 10.1007/s00268-011-1275-4 – volume: 120 start-page: 2650 issue: 12 year: 2007 end-page: 2655 ident: CR19 article-title: Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: analysis of 5,613 cases from a medical center in southern Taiwan publication-title: Int J Cancer doi: 10.1002/ijc.22616 – year: 2009 ident: CR6 publication-title: AJCC cancer staging manual – volume: 34 start-page: 529 issue: 3 year: 2001 end-page: 534 ident: CR21 article-title: Discrimination value of the new western prognostic system (CLIP score) for hepatocellular carcinoma in 662 Japanese patients. Cancer of the Liver Italian Program publication-title: Hepatology doi: 10.1053/jhep.2001.27219 – volume: 255 start-page: 908 issue: 5 year: 2012 end-page: 915 ident: CR12 article-title: Should adenocarcinoma of the esophagogastric junction be classified as esophageal cancer? A comparative analysis according to the seventh AJCC TNM classification publication-title: Ann Surg doi: 10.1097/SLA.0b013e31824beb95 – volume: 14 start-page: 101 issue: 2 year: 2011 end-page: 112 ident: CR17 article-title: Japanese classification of gastric carcinoma: 3rd English edition publication-title: Gastric Cancer doi: 10.1007/s10120-011-0041-5 – volume: 19 start-page: 2443 issue: 8 year: 2012 end-page: 2451 ident: CR11 article-title: The New American Joint Committee on Cancer/International Union Against Cancer staging system for adenocarcinoma of the stomach: increased complexity without clear improvement in predictive accuracy publication-title: Ann Surg Oncol doi: 10.1245/s10434-012-2403-6 – year: 2017 ident: CR13 publication-title: TNM classification of maligant tumours – volume: 5 start-page: 1 issue: 1 year: 2002 end-page: 5 ident: CR18 article-title: Gastric cancer treatment guidelines in Japan publication-title: Gastric Cancer doi: 10.1007/s101200200000 – year: 2009 ident: CR5 publication-title: TNM classification of malignant tumours – volume: 27 start-page: 2 issue: 1 year: 2015 end-page: 12 ident: CR3 article-title: Annual report on status of cancer in China, 2011 publication-title: Chin J Cancer Res doi: 10.1186/s40880-015-0001-2 – volume: 14 start-page: 166 issue: 2 year: 2011 end-page: 171 ident: CR7 article-title: The effectiveness of the new (7th) UICC N classification in the prognosis evaluation of gastric cancer patients: a comparative study between the 5th/6th and 7th UICC N classification publication-title: Gastric Cancer doi: 10.1007/s10120-011-0024-6 – volume: 20 start-page: 217 issue: 2 year: 2017 end-page: 225 ident: CR15 article-title: Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association staging project publication-title: Gastric Cancer doi: 10.1007/s10120-016-0601-9 – volume: 1 start-page: 505 issue: 4 year: 2015 end-page: 527 ident: CR1 article-title: The global burden of cancer 2013 publication-title: JAMA Oncol doi: 10.1001/jamaoncol.2015.0735 – volume: 29 start-page: 1 issue: 1 year: 2017 end-page: 10 ident: CR4 article-title: Cancer incidence and mortality in China in 2013: an analysis based on urbanization level publication-title: Chin J Cancer Res doi: 10.21147/j.issn.1000-9604.2017.01.01 – volume: 255 start-page: 486 issue: 3 year: 2012 end-page: 491 ident: CR9 article-title: Prognostic value of the 7th AJCC/UICC TNM classification of noncardia gastric cancer: analysis of a large series from specialized Western centers publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182389b1a – volume: 120 start-page: 2650 issue: 12 year: 2007 ident: 779_CR19 publication-title: Int J Cancer doi: 10.1002/ijc.22616 – volume: 34 start-page: 529 issue: 3 year: 2001 ident: 779_CR21 publication-title: Hepatology doi: 10.1053/jhep.2001.27219 – volume: 14 start-page: 166 issue: 2 year: 2011 ident: 779_CR7 publication-title: Gastric Cancer doi: 10.1007/s10120-011-0024-6 – volume: 19 start-page: 1918 issue: 6 year: 2012 ident: 779_CR10 publication-title: Ann Surg Oncol doi: 10.1245/s10434-011-2206-1 – volume-title: TNM classification of maligant tumours year: 2017 ident: 779_CR13 – volume: 14 start-page: 101 issue: 2 year: 2011 ident: 779_CR17 publication-title: Gastric Cancer doi: 10.1007/s10120-011-0041-5 – volume-title: AJCC cancer staging manual year: 2009 ident: 779_CR6 – volume: 14 start-page: 113 issue: 2 year: 2011 ident: 779_CR16 publication-title: Gastric Cancer doi: 10.1007/s10120-011-0042-4 – volume: 27 start-page: 2 issue: 1 year: 2015 ident: 779_CR3 publication-title: Chin J Cancer Res doi: 10.1186/s40880-015-0001-2 – volume-title: TNM classification of malignant tumours year: 2009 ident: 779_CR5 – volume: 29 start-page: 1 issue: 1 year: 2017 ident: 779_CR4 publication-title: Chin J Cancer Res doi: 10.21147/j.issn.1000-9604.2017.01.01 – volume: 1 start-page: 505 issue: 4 year: 2015 ident: 779_CR1 publication-title: JAMA Oncol doi: 10.1001/jamaoncol.2015.0735 – volume: 35 start-page: 2723 issue: 12 year: 2011 ident: 779_CR8 publication-title: World J Surg doi: 10.1007/s00268-011-1275-4 – volume: 136 start-page: E359 issue: 5 year: 2015 ident: 779_CR2 publication-title: Int J Cancer doi: 10.1002/ijc.29210 – volume: 255 start-page: 908 issue: 5 year: 2012 ident: 779_CR12 publication-title: Ann Surg doi: 10.1097/SLA.0b013e31824beb95 – volume: 19 start-page: 2443 issue: 8 year: 2012 ident: 779_CR11 publication-title: Ann Surg Oncol doi: 10.1245/s10434-012-2403-6 – volume: 5 start-page: 1 issue: 1 year: 2002 ident: 779_CR18 publication-title: Gastric Cancer doi: 10.1007/s101200200000 – volume: 103 start-page: 1835 issue: 7 year: 2008 ident: 779_CR20 publication-title: Am J Gastroenterol doi: 10.1111/j.1572-0241.2008.01959_3.x – volume: 255 start-page: 486 issue: 3 year: 2012 ident: 779_CR9 publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182389b1a – volume-title: AJCC cancer staging manual year: 2017 ident: 779_CR14 doi: 10.1007/978-3-319-40618-3 – volume: 20 start-page: 217 issue: 2 year: 2017 ident: 779_CR15 publication-title: Gastric Cancer doi: 10.1007/s10120-016-0601-9 |
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| Snippet | Background
We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.
Methods
The... We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer. The survival outcomes... BackgroundWe investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.MethodsThe... We investigated the superiority of the 8th edition of the tumor-node-metastasis (TNM) system for patients in China with gastric cancer.BACKGROUNDWe... |
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| StartPage | 643 |
| SubjectTerms | Abdominal Surgery Cancer Research Gastric cancer Gastroenterology Medicine Medicine & Public Health Metastases Metastasis Oncology Original Original Article Surgical Oncology Survival |
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| Title | The 8th edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for gastric cancer is superior to the 7th edition: results from a Chinese mono-institutional study of 1663 patients |
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