Abstract
Background
The 8th edition of the AJCC TNM staging system for gastric cancer was released in
2016 and included major revisions, especially of stage III.
Patients and Methods
Data from 3281 patients with GC who underwent R0 resection between December 2006 and
November 2014 were reviewed. Of them, 1579 patients with stage III according to the
seventh edition were analyzed and the 7th and 8th TNM classifications were compared.
Results
The most important tumor stages change observed in stage III GC. For stage III patients,
the median number of lymph nodes (LNs) resected in stage III patients was 33 (range
5–112), and the optimal cut-off value for the number of LNs resected was 30. Although
the 7th edition classification had higher c-index, linear trend and likelihood ratio
χ2 scores, and smaller AIC values compared with those for the 8th edition, which represented
the optimum prognostic stratification, however, the differences between 7th and 8th
edition seems to be not statistically significant, and AIC demonstrates similar trend
as well. Further subgroup analysis found that the 8th staging system generated the
marginally better prognostic stratification only when LNs removed ≥30.
Conclusion
The 8th TNM classification may provide better accuracy than 7th edition in predicting
the prognosis of stage III GC after R0 resection with LNs harvested ≥30. However,
further research in an external validation setting is warranted.
Keywords
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Article info
Publication history
Published online: September 12, 2017
Accepted:
September 1,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
