Oncotarget

Research Papers:

Comparison of the 7th and 8th editions of the American joint committee on cancer TNM classification for patients with stage III gastric cancer

Jun Lu, Chao-Hui Zheng, Long-Long Cao, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Mi Lin, Ru-hong Tu and Chang-Ming Huang _

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Oncotarget. 2017; 8:83555-83562. https://doi.org/10.18632/oncotarget.18375

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Abstract

Jun Lu1,2,3,4, Chao-Hui Zheng1,2,3,4, Long-Long Cao1,2,3,4, Ping Li1,2,3,4, Jian-Wei Xie1,2,3,4, Jia-Bin Wang1,2,3,4, Jian-Xian Lin1,2,3,4, Qi-Yue Chen1,2,3,4, Mi Lin1,2,3,4, Ru-Hong Tu1,2,3,4 and Chang-Ming Huang1,2,3,4

1Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

2Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

3Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

4Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China

Correspondence to:

Chang-Ming Huang, email: [email protected]

Keywords: gastric cancer, TNM classification, prognosis, 8th edition

Received: February 02, 2017     Accepted: April 26, 2017     Published: June 06, 2017

ABSTRACT

Background and Objectives: The eighth TNM edition for gastric cancer was released in 2016 and included major revisions, especially of stage III. The purpose of this study was to evaluate the prognostic value of the new AJCC TNM classification in comparison with the 7th edition for stage III gastric cancer.

Methods: Clinical and histopathological data on 1,496 patients operated on for stage III GC according to the seventh edition between 2005 and 2013 were analyzed and compared using 7th and 8th classifications. The 2 systems were compared in terms of prognostic performance.

Results: The stage shifted for 650 (43.45%) patients: from IIIA to IIIB (2 patient, 0.13%), from IIIB to IIIA (214 patients, 14.30%), from IIIB to IIIC (99 patients, 6.62%), and from IIIC to IIIB (335 patients, 22.39%). Cox regression multivariate analysis showed both the 8th and 7th TNM classification were independent prognostic factors. The 8th edition system had higher linear trend and likelihood ratio χ2 scores, and smaller AIC values compared with those for the 7th edition. However, the performance of the eighth edition did not reveal significant improvement compared to the seventh edition (c-index 0.625 vs. c-index 0.616, p=0.085).

Conclusion: The eighth TNM edition may not provide significantly better accuracy in predicting the prognosis of stage III GC. However, to confirm our findings, further studies are warranted.


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