alexa Validating the prognostic and discriminating value of the TNM-classification for gastric cancer - a critical appraisal.


Evidence based Medicine and Practice

Author(s): Rcken C, Behrens HM

Abstract Share this page

Abstract AIM: We investigated the effect of the new tumour-, node-, metastasis- (TNM) classification on predicting and discriminating gastric cancer patient prognosis using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program. PATIENTS AND METHODS: From the SEER-database we retrieved gastric cancer patients with a primary adenocarcinoma, of Caucasian or Asian ethnicity and without distant metastases (M0). The pTNM-stage was determined according to the 7th edition of the union internationale contre le cancer (UICC) guidelines. RESULTS: Spanning the period 2004-2010, 6136 patients fulfilled all inclusion criteria including 3424 (55.8\%) men, 2712 (44.2\%) women, 4629 (75.4\%) Caucasian and 1507 (24.6\%) Asian patients. 1524 (24.8\%) patients underwent total gastrectomy and 4612 (75.2\%) non-total gastrectomy. Only in 41.2\% of the patients were >15 lymph nodes resected. 1857 (31.0\%) patients received radiotherapy. Patient survival depended on ethnicity, type of surgery and radiotherapy. The discriminating value of the UICC-stage grouping could not be validated for Caucasian patients with >15 lymph nodes resected and who had not received radiotherapy: stage groups IIB, IIIA, IIIB and IIIC showed substantial overlap in survival ranges. In addition, the tumour specific survival of the different T-/N-combinations was significantly different in stage groups IIIB and IIIC, respectively. CONCLUSIONS: Our retrospective analysis of the SEER-database does not validate the discriminating value of stage grouping of the 7th edition of the UICC-stage grouping. A revision should be considered and more reliable prognostic biomarkers are urgently needed. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved. This article was published in Eur J Cancer and referenced in Evidence based Medicine and Practice

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version