Subclassification of pT2 gastric adenocarcinoma according to depth of invasion (pT2a vs pT2b) and lymph node status (pN)

Park, Do Joong; Kong, Seong‐Ho; Lee, Hyuk-Joon; Kim, Woo Ho; Yang, Han–Kwang; Lee, Kuhn Uk; Choe, Kuk Jin

doi:10.1016/j.surg.2007.01.023

Cited by 49 publications

(60 citation statements)

References 10 publications

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“…However, modifying the pT2 classification has been proposed because the prognosis of patients with pT2a and pT2b disease was found to differ with statistical significance. [8][9][10] In the current study, the 5-year survival rate of patients with the sixth edition pT2a classification was also significantly better compared with that of patients with pT2b disease (89.0% vs 63.9%; P <.05). Therefore, it appears reasonable to revise the six edition pT2(a/b) to different pT classification.…”

Section: 13supporting

confidence: 51%

“…Several investigators have proposed that the sixth edition pT2 classification should be subclassified as muscularis propria and subserosa cancer for better prediction of prognosis. [8][9][10] In this context, the seventh edition of the AJCC TNM classification for gastric cancer was published in 2010 and included major revisions of the pT and pN classifications.…”

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confidence: 99%

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Validation of the seventh edition of the American Joint Committee on Cancer TNM staging system for gastric cancer

Jung

Lee

Song

et al. 2011

Cancer

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BACKGROUND:The seventh edition of the American Joint Committee on Cancer (AJCC) TNM classification for gastric cancer was published in 2010 and included major revisions. The aim of the current study was to evaluate the validity of the seventh edition TNM classification for gastric cancer based on an Asian population. METHODS: A total of 2916 gastric cancer patients who underwent R0 surgical resection from 1989 through 2008 in a single institute were included, and were analyzed according to the seventh edition of the TNM classification for validation. RESULTS: When adjusted using the seventh edition of the TNM classification, upstaging was observed in 771 patients (26.4%) and downstaging was observed in 178 patients (6.1%) compared with the sixth edition of the TNM classification. The relative risk (RR) of seventh edition pT classification was found to be increased with regular intensity compared with the sixth edition pT classification. The RR of seventh edition pN classification was found to be increased with irregular intensity compared with the sixth edition pN classification. In survival analysis, there were significant differences noted for each stage of disease, but only a marginal difference was demonstrated between stage IA and stage IB (P ¼ .049). In the hybrid TNM classification, which combines the seventh edition pT classification and the sixth edition pN classification, both pT and pN classifications demonstrated a more ideal distribution of the RR, and 5-year survival rates also showed a significant difference for each stage (P <.01). CONCLUSIONS: The seventh edition of the TNM classification was considered valid based on the results of the current study. However, the hybrid TNM classification, comprised of a combination of the seventh edition pT classification and sixth edition pN classification, should be considered for the next edition.

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Section: 13supporting

confidence: 51%

mentioning

confidence: 99%

Validation of the seventh edition of the American Joint Committee on Cancer TNM staging system for gastric cancer

Jung

Lee

Song

et al. 2011

Cancer

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“…In order to further explore the cause of the downregulation of ARHI in gastric cancers, MSP was carried out to analyze the status of CpG islands of ARHI in pT2a and pT2b stage cancers. Loss of ARHI expression occurring through DNA methylation has been demonstrated in breast and ovarian cancer (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). We designed three pairs of primers to detect three CpG islands of the ARHI gene.…”

Section: Discussionmentioning

confidence: 99%

“…In the sixth edition of the International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) staging manual, the pT2 category was subclassified into pT2a and pT2b based on the depth of tumor invasion (17). pT2a and pT2b, respectively, represent the tumor invaded to the muscularis propria (MP) and subserosa (SS) layer (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

The expression of ARHI in pT2a and pT2b stage gastric cancer and its clinical significance

Wang

et al. 2012

Oncol Rep

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Abstract. ARHI is a novel tumor suppressor gene located on chromosome 1p31. Downregulation of ARHI expression has been detected in many types of cancer. However, the effects of ARHI in gastric cancer remain unclear. The aim of this study was to identify the relationship between ARHI expression and gastric cancer clinicopathological features. In this study, 81 pT2 stage gastric cancer specimens were subclassified by pT2a and pT2b stage. ARHI mRNA and protein levels were evaluated by real-time PCR and western blot analysis, respectively. Methylation plays an important role in suppressor gene silencing. We utilized methylation-specific PCR to identify the status of CpG islands in the ARHI gene. We used immunohistochemistry to determine the expression of the protein and analyzed clinicopathological features. The levels of ARHI mRNA in gastric cancer were lower compared to normal tissues (P<0.01). Similarly, the levels of ARHI protein in the cancer specimens were lower (P<0.05). DNA hypermethylation was identified in 79.1% of gastric cancer specimens without ARHI expression. Immunohistochemistry results were significantly correlated with the pT2 category (P<0.05). The cumulative survival rate of patients with ARHI expression was significantly higher compared to those without ARHI expression (P<0.05). ARHI as a suppressor is not only an important factor in the pathogenesis of gastric cancer, but also a potential factor for tumor aggravation. ARHI expression in gastric cancer can be employed to indicate favorable prognosis for the disease.

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“…Although patients with stage I disease after curative resection have good prognosis, especially early gastric cancer regardless of lymph node metastasis status, some patients still die due to disease recurrence (40). Stage I disease includes advanced gastric cancer without lymph node metastasis (T2N0), among which gastric cancers with invasion of the subserosa are reported to have unfavorable prognosis with 5-year DSS of 77.2% (41). However, such patients have not received adjuvant chemotherapy, and it is, therefore, indispensable to select patients with stage I disease who will benefit from adjuvant chemotherapy in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Phosphatase of regenerating liver-3 as a prognostic biomarker in histologically node-negative gastric cancer

Watanabe¹

2009

Oncol Rep

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Subclassification of pT2 gastric adenocarcinoma according to depth of invasion (pT2a vs pT2b) and lymph node status (pN)

Cited by 49 publications

References 10 publications

Validation of the seventh edition of the American Joint Committee on Cancer TNM staging system for gastric cancer

Validation of the seventh edition of the American Joint Committee on Cancer TNM staging system for gastric cancer

The expression of ARHI in pT2a and pT2b stage gastric cancer and its clinical significance

Phosphatase of regenerating liver-3 as a prognostic biomarker in histologically node-negative gastric cancer

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