Evaluation of the 5th edition of the TNM classification for gastric cancer: improved prognostic value.
Evaluation of the 5th edition of the TNM classification for gastric cancer: improved prognostic value.
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DOI：
10.1054/bjoc.2000.1548
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发表时间：
2001-01-05
影响因子：
8.8
通讯作者：
van de Velde CJ
中科院分区：
文献类型：
--
作者：
Klein Kranenbarg E;Hermans J;van Krieken JH;van de Velde CJ
1997年第5版胃癌TNM分类与1987年第4版相比的主要变化是使用受累结节的数目而不是阳性结节的位置。因此，阶段分组也被更改。第二个变化是要求检查至少15个节点以证明N0状态是正确的。检查阴性结节较少的患者无法分类(NX)。数据从比较D1和D2夹层的随机试验数据库中检索，包括633名接受手术治疗的患者。根据第5版标准，与第4版相比，39%的结节阳性患者有另一个N期：21%的患者有较低的N期，18%的患者有较高的N期。按第4版N0、N1和N2组计算，5年生存率分别为72%、34%和27%。第5版N0、N1、N2、N3、NX组的百分比分别为75%、38%、19%、8%、65%。原来的1987年N1和N2组被显著地分成3个新的N1997组(P=0.006，分别P<；0.0005)。Cox‘s回归分析显示，N1997分类是最重要的预后变量，其预后价值高于N1987。此外，新的TNM分期也是一个更好的预测因素。然而，在所有淋巴结阴性的患者中，有38%的患者无法满足检查至少15个淋巴结的要求，我们发现至少5个连续阴性的淋巴结是一个可靠的分期数字。我们的结论是，第5版的TNM分类提供了更好的预后估计，然而，检查至少15个阴性区域淋巴结的阈值太高，5个给出了类似的预后价值。©2001癌症研究活动http://www.bjcancer.com
The main change in the 5th edition (1997) of the TNM classification for gastric cancer compared to the 4th edition (1987) is the use of the number of involved nodes instead of the location of positive nodes. As a result stage grouping is also altered. A second change is the requirement for the examination of at least 15 nodes to justify the N0 status. Patients with fewer examined negative nodes are unclassifiable (Nx). Data were retrieved from a randomized trial database comparing D1 and D2 dissection and 633 curatively operated patients were included. According to the criteria of the 5th edition, 39% of the node-positive patients had another N stage compared to the 4th: 21% had a lower and 18% had a higher stage. 5-year survival rates according to the 4th edition N0, N1 and N2 groups were respectively 72%, 34% and 27%. According to the 5th edition these percentages were for the N0, N1, N2, N3 and Nx groups respectively 75%, 38%, 19%, 8% and 65%. The former 1987 N1 and N2 group were significantly split into three new N 1997 groups (P = 0.006, respectively P< 0.0005). The Cox's regression analysis showed the N 1997 classification to be the most important prognostic variable, with a higher prognostic value than N 1987. In addition, the new TNM stage was also a better prognosticator. The requirement for examining at least 15 nodes, however, could not be fulfilled in 38% of all node-negative patients and we found that a minimum of 5 consecutive negative lymph nodes is a reliable number for staging purposes. We conclude that the 5th edition of the TNM classification provides a better estimation of prognosis, however, examination of at least 15 negative regional lymph nodes is too high a threshold and 5 gives similar prognostic value. © 2001 Cancer Research Campaign http://www.bjcancer.com
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影响因子：
9.6
作者：
WAGNER, PK;RAMASWAMY, A;ROTHMUND, M
通讯作者：
ROTHMUND, M
影响因子：
2.6
作者：
de Manzoni, G;Verlato, G;Cordiano, C
通讯作者：
Cordiano, C
DOI：
10.1016/s0748-7983(98)93536-3
发表时间：
1998-12-01
期刊：
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY
影响因子：
--
作者：
Hermanek, P;Altendorf-Hofmann, A;Hohenberger, W
通讯作者：
Hohenberger, W
影响因子：
9.6
作者：
SIEWERT, JR;BOTTCHER, K;MEYER, HJ
通讯作者：
MEYER, HJ
影响因子：
9.6
作者：
Fujii, K;Isozaki, H;Tanigawa, N
通讯作者：
Tanigawa, N