Chun-Wei Peng1, Lin-Wei Wang, Wei-Juan Zeng, Xiao-Jun Yang, Yan Li. 1. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, PR China.
Abstract
BACKGROUND: Some staging systems for gastric cancer (GC) have been developed as alternatives to the 6th and 7th TNM staging systems, including the Hybrid, tumor-ratio-metastasis (TRM), and Kiel staging systems. This study evaluated the overall performance of these systems for GC. METHODS: A total of 540 GC patients undergoing surgical resection were staged using these five systems. Homogeneity, discrimination power, predictive accuracy, and complexity of these systems were compared. RESULTS: Multivariate analyses showed that all of 7th pT, pN, and pM classifications were independent factors for GC prognosis (P < 0.001 for all). Compared with the other four systems, 7th TNM system had improved stage groups homogeneity (7 of 8 stage groups homogeneous), enhanced discrimination power (4 of 5, 5 of 7, 4 of 7, 3 of 7, and 1 of 4 adjacent stage groups were differentiated by the 6th, 7th TNM, Hybrid, TRM, and Kiel systems, respectively), and better prediction value for GC patients' outcome (AUC = 0.801, P < 0.001). In addition, the 7th TNM system did not increase the staging complexity (9 groups and 21 subgroups). CONCLUSIONS: The 7th TNM staging system represents advancement in GC staging system for better prediction of clinical outcomes.
BACKGROUND: Some staging systems for gastric cancer (GC) have been developed as alternatives to the 6th and 7th TNM staging systems, including the Hybrid, tumor-ratio-metastasis (TRM), and Kiel staging systems. This study evaluated the overall performance of these systems for GC. METHODS: A total of 540 GC patients undergoing surgical resection were staged using these five systems. Homogeneity, discrimination power, predictive accuracy, and complexity of these systems were compared. RESULTS: Multivariate analyses showed that all of 7th pT, pN, and pM classifications were independent factors for GC prognosis (P < 0.001 for all). Compared with the other four systems, 7th TNM system had improved stage groups homogeneity (7 of 8 stage groups homogeneous), enhanced discrimination power (4 of 5, 5 of 7, 4 of 7, 3 of 7, and 1 of 4 adjacent stage groups were differentiated by the 6th, 7th TNM, Hybrid, TRM, and Kiel systems, respectively), and better prediction value for GC patients' outcome (AUC = 0.801, P < 0.001). In addition, the 7th TNM system did not increase the staging complexity (9 groups and 21 subgroups). CONCLUSIONS: The 7th TNM staging system represents advancement in GC staging system for better prediction of clinical outcomes.
Authors: Francesco Giganti; Elena Orsenigo; Paolo Giorgio Arcidiacono; Roberto Nicoletti; Luca Albarello; Alessandro Ambrosi; Annalaura Salerno; Antonio Esposito; Maria Chiara Petrone; Damiano Chiari; Carlo Staudacher; Alessandro Del Maschio; Francesco De Cobelli Journal: Gastric Cancer Date: 2015-01-23 Impact factor: 7.370
Authors: Francesco Giganti; Alessandro Ambrosi; Maria C Petrone; Carla Canevari; Damiano Chiari; Annalaura Salerno; Paolo G Arcidiacono; Roberto Nicoletti; Luca Albarello; Elena Mazza; Francesca Gallivanone; Luigi Gianolli; Elena Orsenigo; Antonio Esposito; Carlo Staudacher; Alessandro Del Maschio; Francesco De Cobelli Journal: Br J Radiol Date: 2016-10-21 Impact factor: 3.039
Authors: Li Tang; Rui Duan; Yan-jun Zhong; Raymond A Firestone; Ya-ping Hong; Ji-guo Li; Yan-chao Xin; Han-lin Wu; Yan Li Journal: Mol Cancer Date: 2014-03-03 Impact factor: 27.401