Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives

Marano, Luigi; D’Ignazio, Alessia; Cammillini, Federico; Angotti, Rossella; Messina, Mario; Marrelli, Daniele; Roviello, Franco

doi:10.21037/tgh.2019.03.09

Cited by 44 publications

(31 citation statements)

References 25 publications

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“…All the patients had complete clinical, pathological, and surgical data, including sex, age, Borrmann type, LBVI status, tumor location, tumor size, histological type, depth of invasion, number of metastatic lymph nodes, surgical method, treatment by combined resection, and 5-year survival rate. Tumor staging was based on the Eighth Edition of the American Joint Committee on Cancer/International Cancer Control Alliance (AJCC/UICC)[ 11 ]. According to the Japanese gastric cancer classification method, AGC is defined as a tumor that invades the muscular lamina or deeper, regardless of the presence of lymph node metastasis[ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Zhai¹,

Zhu²,

Zhang³

et al. 2020

WJGO

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BACKGROUND Borrmann classification (types I-IV) for the detection of advanced gastric cancer has been accepted worldwide, and lymphatic and/or blood vessel invasion (LBVI) status is related to the poor prognosis after gastric cancer. AIM To evaluate the significance of Borrmann type combined with LBVI status in predicting the prognosis of advanced gastric cancer. METHODS We retrospectively studied the clinicopathological characteristics and long-term survival data of 2604 patients who were diagnosed with advanced gastric adenocarcinoma at Harbin Medical University Cancer Hospital from January 2009 to December 2013. Categorical variables were evaluated by the Pearson’s χ 2 test, the Kaplan-Meier method was used to identify differences in cumulative survival rates, and the Cox proportional hazards model was used for multivariate prognostic analysis. RESULTS A total of 2604 patients were included in this study. The presence of LVBI [LBVI (+)] and Borrmann type ( P = 0.001), tumor location ( P < 0.001), tumor size ( P < 0.001), histological type ( P < 0.001), tumor invasion depth ( P < 0.001), number of metastatic lymph nodes ( P < 0.001), and surgical method ( P < 0.001) were significantly correlated with survival. When analyzing the combination of the Borrmann classification and LBVI status, we found that patients with Borrmann type III disease and LBVI (+) had a similar 5-year survival rate to those with Borrmann IV + LBVI (-) (16.4% vs 13.1%, P = 0.065) and those with Borrmann IV + LBVI (+) (16.4% vs 11.2%, P = 0.112). Subgroup analysis showed that the above results were true for any pT stage and any tumor location. Multivariate Cox regression analysis showed that Borrmann classification ( P = 0.023), vascular infiltration ( P < 0.001), tumor size ( P = 0.012), pT stage ( P < 0.001), pN stage ( P < 0.001), and extent of radical surgery ( P < 0.001) were independent prognostic factors for survival. CONCLUSION Since patients with Borrmann III disease and LBVI (+) have the same poor prognosis as those with Borrmann IV disease, more attention should be paid to patients with Borrmann III disease and LBVI (+) during diagnosis and treatment, regardless of the pT stage and tumor location, to obtain better survival results.

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Section: Methodsmentioning

confidence: 99%

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Zhai¹,

Zhu²,

Zhang³

et al. 2020

WJGO

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“…According to historical literature, the TNM stage of 8th edition is determined by the number of metastatic lymph nodes. It is an international consensus that 15 or more metastatic lymph nodes must be removed during radical gastrectomy [14]. However, the di culties and technical gaps in lymph node selection from postoperative specimens,even tiny lymph nodes, and the gap of technical in dissect lymph node by surgeons will lead to staging migration, affect the stage, which will affect the prognosis of patients due to the wrong postoperative treatment schedule.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of N1 and N2 Metastatic Lymph Node Ratio After Distal Gastric Cancer Surgery

Bai¹,

Wang²,

Yang³

2020

Preprint

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OBJECTIVE: To investigate prognostic significance of n1 and n2 station metastatic lymph node ratio(rN) after distal gastric cancer surgery. METHODS: A total of 408 patients who underwent radical distal gastrectomy (D2) under general anesthesia in 2012-2014. The critical value of rN1 and rN2 were calculated respectively. Prognostic factors were identified by univariate and multivariate analyses.RESULTS: An rN1 of 0.140 and rN2 of 0.100 was found to be the best cut-off value to determine the prognosis of patients with distal gastric cancer (p < 0.001).Univariate and multivariate analysis show that gender, age, nerves invaded, carcinoma nodules, LNS, LNS1, LNS2 were non-prognostic factors.tumor size, depth of invasion,blood vessels invaded,degree of differentiation,rN, PLNS1,rN1, PLNS2, rN2,pTNM were prognostic factors. Among prognostic factors, the partial regression coefficients were, from high to low, pTNM, rN2, rN2, rN. CONCLUSION: RN1 and RN2 is a better prognostic tool for gastric cancer patients after curative distal gastrectomy.which is a beneficial and reliable technique for evaluating lymph node metastasis.

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“…Tissue types were divided into highly, moderately, and lowly differentiated and undifferentiated. Tumor staging was based on the Seventh Edition of the American Joint Committee on Cancer/International Union for Cancer Control[ 18 , 19 ]. Early GC was defined as a tumor limited to the mucosa or submucosa according to the Japanese Society of Gastric Cancer Research[ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Changing trends of clinicopathologic features and survival duration after surgery for gastric cancer in Northeast China

Zhai

Zhu

Cong

et al. 2020

WJGO

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BACKGROUND Through analyzing the data from a single institution in Northeast China, this study revealed the possible clinicopathologic characteristics that influence the prognosis of patients with gastric cancer (GC). AIM To evaluate the changing trends of clinicopathologic features and survival duration after surgery in patients with GC in Northeast China, which is a high-prevalence area of GC. METHODS The study analyzed the difference in clinicopathologic features and survival duration after surgery of 5887 patients who were histologically diagnosed with GC at the Harbin Medical University Cancer Hospital. The study mainly analyzed the data in three periods, 2000 to 2004 (Phase 1), 2005 to 2009 (Phase 2), and 2010 to 2014 (Phase 3). RESULTS Over time, the postoperative survival rate significantly increased from 2000 to 2014. In the past 15 years, compared with Phases 1 and 2, the tumor size was smaller in Phase 3 ( P < 0.001), but the proportion of high-medium differentiated tumors increased ( P < 0.001). The proportion of early GC gradually increased from 3.9% to 14.4% ( P < 0.001). A surprising improvement was observed in the mean number of retrieved lymph nodes, ranging from 11.4 to 27.5 ( P < 0.001). The overall 5-year survival rate increased from 24% in Phase 1 to 43.8% in Phase 3. Through multivariate analysis, it was found that age, tumor size, histologic type, tumor-node-metastasis stage, depth of invasion, lymph node metastasis, surgical approach, local infiltration, radical extent, number of retrieved lymph nodes, and age group were independent risk factors that influenced the prognosis of patients with GC. CONCLUSION The clinical features of GC in Northeast China changed during the observation period. The increasing detection of early GC and more standardized surgical treatment effectively prolonged lifetimes.

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Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives

Abstract: between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives. Transl Gastroenterol Hepatol 2019;4:22.

Cited by 44 publications

References 25 publications

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Prognostic Significance of N1 and N2 Metastatic Lymph Node Ratio After Distal Gastric Cancer Surgery

Changing trends of clinicopathologic features and survival duration after surgery for gastric cancer in Northeast China

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Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives

Abstract: between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives. Transl Gastroenterol Hepatol 2019;4:22.

Cited by 44 publications

References 25 publications

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Prognostic significance of Borrmann type combined with vessel invasion status in advanced gastric cancer

Prognostic Significance of N1 and N2&nbsp;Metastatic Lymph Node Ratio After Distal Gastric Cancer Surgery

Changing trends of clinicopathologic features and survival duration after surgery for gastric cancer in Northeast China

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Prognostic Significance of N1 and N2 Metastatic Lymph Node Ratio After Distal Gastric Cancer Surgery