Cohort Study Based on the Seventh Edition of the TNM Classification for Gastric Cancer: Proposal of a New Staging System
Cohort Study Based on the Seventh Edition of the TNM Classification for Gastric Cancer: Proposal of a New Staging System
复制标题
DOI：
10.1200/jco.2010.34.4358
复制
发表时间：
2011-06-10
影响因子：
45.3
通讯作者：
Roecken, Christoph
中科院分区：
文献类型：
--
作者：
Warneke, Viktoria S.;Behrens, Hans-Michael;Roecken, Christoph
PurposeWe调查了胃癌stagger.Patients和MethodsFrom医院的记录，从胃癌患者，谁经历了全部或部分胃切除术的胃或食管胃交界处的腺癌，信息的新的TNM分类的效果。病理TNM分期根据国际抗癌联盟第六版和第七版指南确定，并基于手术病理检查。（338名男子和216名妇女;中位年龄，68岁）因肠（n = 209）或弥漫性（n = 249）而接受部分或完全胃切除术食管胃交界处和胃的腺癌。所有患者的生存数据和死亡日期均可用。患者死亡与诊断时的年龄、肿瘤类型、组织学分级、局部肿瘤生长（T分类）、转移性淋巴结数量、淋巴结比率、淋巴结状态（N分类）和肿瘤分期显著相关。第六版和第七版TNM分类之间没有重大差异。根据生存数据，我们修改了分期分组系统; I期和II期肿瘤仅限于非转移性肿瘤，III期和IV期肿瘤仅限于转移性肿瘤。Kaplan-Meier图的修改阶段分组显示，没有交叉曲线的个体阶段亚组之间的统计学显着差异，并表现出改善的生存期II期diseases.ConclusionThe第七版的TNM分类与60%的食管胃和胃癌患者的阶段迁移。这一变化并没有改善患者预后的评估，因此，提出了一个修订的分期系统。J Clin Oncol 29：2364-2371. (C)2011年美国临床肿瘤学会
PurposeWe investigated the effect of the new TNM classification on gastric cancer staging.Patients and MethodsFrom hospital records, information from patients with gastric cancer, who had undergone either total or partial gastrectomy for adenocarcinomas of the stomach or esophagogastric junction, was retrieved. The pathologic TNM stage was determined according to the sixth and seventh editions of the International Union Against Cancer guidelines and was based on surgical pathologic examination.ResultsFive hundred fifty-four patients (338 men and 216 women; median age, 68 years) had undergone partial or complete gastrectomy for intestinal (n = 209) or diffuse (n = 249) adenocarcinoma of the esophagogastric junction and stomach. Survival data and date of death were available for all patients. Patient death correlated significantly with age at diagnosis, tumor type, histologic grade, local tumor growth (T category), number of metastatic lymph nodes, lymph node ratio, lymph node status (N category), and tumor stage. No major difference was noted between the sixth and seventh editions of the TNM classification. On the basis of survival data, we revised the stage grouping system; stage I and II tumors were confined to nonmetastatic tumors, and stage III and IV tumors were confined to metastatic tumors. The Kaplan-Meier plots of this modified stage grouping showed statistically significant differences between individual stage subgroups without crossing curves and demonstrated improved survival of patients with stage II disease.ConclusionThe seventh edition of the TNM classification is associated with a stage migration in 60% of patients with esophagogastric and stomach cancer. This change did not improve the assessment of patient prognosis, and therefore, a revised staging system is proposed. J Clin Oncol 29:2364-2371. (C) 2011 by American Society of Clinical Oncology