Validation of the prognostic impact of the new tumor-node-metastasis clinical staging in patients with gastric cancer
Validation of the prognostic impact of the new tumor-node-metastasis clinical staging in patients with gastric cancer
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DOI：
10.1007/s10120-018-0799-9
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发表时间：
2019-01-01
期刊：
影响因子：
7.4
通讯作者：
Terashima, Masanori
中科院分区：
文献类型：
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作者：
Bando, Etsuro;Makuuchi, Rie;Terashima, Masanori
在第8版肿瘤-淋巴结-转移（TNM）分类中，胃癌分期系统包括临床分期（cStage）和术后病理分期。然而，新的cStage与总生存期之间的相关性尚未得到研究。此外，临床N （cN）分级分析不包括在新的临床分期系统中。本研究验证了第8版TNM分级中cStage的预后价值以及N分级对胃癌预处理分期的意义。方法选取在静冈癌症中心接受手术治疗的4374例原发性胃癌患者。根据TNM第8版新提出的cStage标准进行生存分析。采用Harrell’s concordance index （C-index）评价预后准确性。结果5年生存率分别为：cStageI为91.2%，cStageIIA为75.1%，cStageIIB为57.7%，cStageIII为43.2%，cStageIVA为31.6%，cStageIVB为7.7%。各阶段间差异均有统计学意义(P
BackgroundIn the 8th edition of the tumor-node-metastasis (TNM) classification, the gastric cancer staging system includes two classifications: the clinical stage (cStage) and the postoperative pathologic stage. However, the correlation between the new cStage and overall survival has not been studied. Moreover, clinical N (cN) grade analysis is not included in the new clinical staging system. This study validated the prognostic value of cStage in the 8th edition of the TNM classification and the significance of N classification for pretreatment staging in gastric cancer.MethodsA total of 4374 patients with primary gastric cancer who underwent surgery at the Shizuoka Cancer Center were included. Survival analysis was conducted based on the newly proposed cStage criteria of the TNM 8th edition. Prognostic accuracy was evaluated using Harrell's concordance index (C-index).ResultsThe five-year survival rates according to cStage were as follows: cStageI, 91.2%, cStageIIA: 75.1%, cStageIIB: 57.7%, cStageIII: 43.2%, cStageIVA: 31.6%, and cStageIVB: 7.7%. Significant differences were observed among all stages (P