Comparison of the 6th and 7th Editions of the UICC TNM Staging System for Gastric Cancer: Results of a Chinese Single-Institution Study of 1,503 Patients
Comparison of the 6th and 7th Editions of the UICC TNM Staging System for Gastric Cancer: Results of a Chinese Single-Institution Study of 1,503 Patients
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DOI：
10.1245/s10434-010-1424-2
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发表时间：
2011-04-01
影响因子：
3.7
通讯作者：
Zhou, Zhi-wei
中科院分区：
文献类型：
--
作者：
Wang, Wei;Sun, Xiao-wei;Zhou, Zhi-wei
为了比较第7版和第6版肿瘤-淋巴结-转移(TNM)分类对胃癌患者预后的影响，采用第6版和第7版分期系统对1,503例接受手术切除的胃癌患者进行分期。采用线性趋势CHI(2)、似然比CHI(2)统计量和Akaike信息准则(AIC)计算比较两种系统的均质性、区分性和梯度的单调性。除第6版系统中的N2期和N3期患者外，T、N和M亚组在第7版系统中的5年生存率有显著差异。在第7版系统中，IB和IIA的存活率没有显著差异。第6版系统中T4/N3引起的IV期疾病患者在第7版系统中被降级至III期的患者的生存率明显好于仍处于IV期的患者。第7版系统与第6版系统相比具有更高的线性趋势和似然比X(2)分数，而较小的AIC值，这代表了最佳的预后分层。
To evaluate the prognostic efficacy of the 7th edition tumor-node-metastasis (TNM) classification compared with the 6th edition in gastric cancer patients.A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend chi(2), likelihood ratio chi(2) statistics, and Akaike information criterion (AIC) calculations.Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio chi(2) scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.