Comparison of the 7th and 6th edition AJCC TNM staging systems for gastric cancer: Analysis of prognosis in a retrospective review of 918 patients at a single institution in China / 肿瘤

ABSTRACT

Objective: To evaluate the prognostic priority of the 7th edition AJCC (American Joint Committee on Cancer) TNM staging system for gastric carcinoma compared with the 6th edition in Chinese population. Methods: A total of 918 patients with gastric carcinoma from a single institution between January 2003 and December 2008 in China were staged using the 6th edition and the 7th edition AJCC TNM staging systems. The univariate and multivariate analyses were applied to evaluate the value of the two staging systems in prognostic prediction for gastric carcinoma. The AIC (Akaike's Information Criterion) was used to determine which is better between the two staging systems. Results: Significant differences in overall survival were observed according to the T, N and M substages using the 7th edition AJCC TNM staging system. The Kaplan-Meier survival curves showed a good discriminatory ability among stages I through IV in both the 6th and 7th edition staging systems (P = 0.000). There were similar survival curves between substages IA and IB (P = 0.643), IB and IIA (P = 0.267), IIB and IIIA (P = 0.534), IIIA and IIIB (P = 0.124), and IIIB and IIIC (P = 0.174) when the patients were classified into eight substages according to the 7th edition AJCC TNM staging system. The AIC value of the 7th edition staging system was smaller than the 6th edition staging system. Conclusion: The 7th edition AJCC TNM staging system is superior to the 6th edition staging system. But the advantage of the new 7th edition staging system is very limited and it presents some deficiencies. Copyright © 2012 by TUMOR.