Reim, Daniel; Loos, Martin; Vogl, Fabian; Novotny, Alexander; Schuster, Tibor; Langer, Rupert; Becker, Karen; Höfler, Heinz; Siveke, Jens; Bassermann, Florian; Friess, Helmut; Schuhmacher, Christoph (2013). Prognostic implications of the seventh edition of the international union against cancer classification for patients with gastric cancer: the Western experience of patients treated in a single-center European institution. Journal of clinical oncology, 31(2), pp. 263-271. American Society of Clinical Oncology 10.1200/JCO.2012.44.4315
Full text not available from this repository.PURPOSE
Validity of the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging systems for gastric cancer has been evaluated in several studies, mostly in Asian patient populations. Only few data are available on the prognostic implications of the new classification system on a Western population. Therefore, we investigated its prognostic ability based on a German patient cohort.
PATIENTS AND METHODS
Data from a single-center cohort of 1,767 consecutive patients surgically treated for gastric cancer were classified according to the seventh edition and were compared using the previous TNM/UICC classification. Kaplan-Meier analyses were performed for all TNM stages and UICC stages in a comparative manner. Additional survival receiver operating characteristic analyses and bootstrap-based goodness-of-fit comparisons via Bayesian information criterion (BIC) were performed to assess and compare prognostic performance of the competing classification systems.
RESULTS
We identified the UICC pT/pN stages according to the seventh edition of the AJCC/UICC guidelines as well as resection status, age, Lauren histotype, lymph-node ratio, and tumor grade as independent prognostic factors in gastric cancer, which is consistent with data from previous Asian studies. Overall survival rates according to the new edition were significantly different for each individual's pT, pN, and UICC stage. However, BIC analysis revealed that, owing to higher complexity, the new staging system might not significantly alter predictability for overall survival compared with the old system within the analyzed cohort from a statistical point of view.
CONCLUSION
The seventh edition of the AJCC/UICC classification was found to be valid with distinctive prognosis for each stage. However, the AJCC/UICC classification has become more complex without improving predictability for overall survival in a Western population. Therefore, simplification with better predictability of overall survival of patients with gastric cancer should be considered when revising the seventh edition.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute of Pathology |
UniBE Contributor: |
Langer, Rupert |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
0732-183X |
Publisher: |
American Society of Clinical Oncology |
Language: |
English |
Submitter: |
Andrea Arnold |
Date Deposited: |
07 Apr 2014 09:30 |
Last Modified: |
05 Dec 2022 14:31 |
Publisher DOI: |
10.1200/JCO.2012.44.4315 |
PubMed ID: |
23213098 |
URI: |
https://boris.unibe.ch/id/eprint/45923 |
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