The effectiveness of the new (7th) UICC N classification in the prognosis evaluation of gastric cancer patients: a comparative study between the 5th/6th and 7th UICC N classification
The effectiveness of the new (7th) UICC N classification in the prognosis evaluation of gastric cancer patients: a comparative study between the 5th/6th and 7th UICC N classification
复制标题
DOI：
10.1007/s10120-011-0024-6
复制
发表时间：
2011-06-01
期刊：
影响因子：
7.4
通讯作者：
Lee, Joo-Ho
中科院分区：
文献类型：
--
作者：
Chae, Sumin;Lee, Anbok;Lee, Joo-Ho
胃癌根治性手术后最重要的预后因素是有无淋巴结转移。根据第7版UICC胃癌TNM分期标准，将N分类为N0(无区域淋巴结转移)、N1(1~2个区域淋巴结转移)、N2(3~6个区域淋巴结转移)和N3(7个或7个以上区域淋巴结转移)。本研究的目的是评估新的UICC/AJCC N分类的合理性，并与UICC的第6分类进行比较。根据第7期UICC N分期，N0、N1、N2、N3a、N3b的5年累计生存率分别为89.7%、73.6%、54.9%、23.1%、5.4%(P<；0.0001)。单因素分析显示，UICC/AJCC第7、6期TNM分期的N分期、第7期的T分期、肿瘤大小、部位、组织学与胃癌根治术后总生存率相关。COX回归多因素分析显示，UICC N分级第7级是独立的预后因素，而不是第6级(P<；0.0001)，UICC第7级淋巴结转移是影响胃癌预后的更可靠因素。
The most important prognostic factor after curative surgery for gastric carcinoma is the presence of lymph node metastases. According to the 7th edition of the UICC TNM staging system for gastric cancer, N classification was categorized as N0 (no regional lymph node metastasis), N1 (1-2 regional lymph node metastases), N2 (3-6 regional lymph node metastases), and N3 (7 or more regional lymph node metastases). The purpose of this study was to evaluate the rationality of the new UICC/AJCC N classification in comparison with the 6th UICC classification.From August 2002 to July 2006, 295 patients with gastric cancer underwent curative resection with D2 lymph node dissection by a single surgeon. We analyzed retrospectively the significant prognostic factors and identified the suitability of the 7th UICC N staging system.According to the 7th UICC N classification, the 5-year cumulative survival rates (5-YSR) of N0, N1, N2, N3a, and N3b were 89.7, 73.6, 54.9, 23.1, and 5.4%, respectively (P < 0.0001). Using univariate analysis, the N classification of the 7th and 6th UICC/AJCC TNM staging system, T classification of the 7th UICC TNM staging system, size and location of tumor, and histology were associated with the overall survival of gastric cancer after curative surgery. However, Cox regression multivariate analysis showed the 7th UICC N classification was an independent prognostic factor instead of the 6th UICC N classification (P < 0.0001).The 7th UICC classification for lymph node metastasis is thought to be a more reliable prognostic factor for gastric cancer than the 6th classification.