Article Abstract

Prognostic prediction in gastric cancer patients without serosal invasion: comparative study between UICC 7th edition and JCGS 13th edition N-classification systems

Authors: Xiang Hu,Liang Cao,Yi Yu


Objective: T-stage and N-stage have been proven to be the most important factors influencing survival in gastric cancer patients, and have been accepted for use in the Japanese Classification of Gastric Carcinoma (JCGC) and the Union International Cancer Control (UICC-TNM) staging systems. The purpose of this study was to compare the prognostic values of the different N classification systems in gastric cancer patients without serosal invasion.

Methods: We retrospectively compared the clinicopathological results of 1,115 patients with primary gastric cancer who underwent curative gastric resection.

Results: Serosal invasion was identified in 212 of 1,115 patients (19.0%), and it was associated with lymph node metastasis according to the JCGC13th (P<0.001) and TNM7th (P<0.001) systems. The 5-year survival rate for the serosal invasion-negative patients (78.2%) was significantly higher than that for the serosal invasion-positive patients (31.1%) (P<0.001). Multivariate Cox regression survival analysis showed that depth of invasion (P=0.013), 13th JCGC PN stage (P<0.001), and 7th TNM PN stage (P<0.001) were independent prognostic factors for serosal invasion-negative gastric cancer patients.

Conclusions: The prognosis of gastric cancer patients with serosal invasion is very poor. Both the 13th JCGC and 7th TNM N-staging systems were able to accurately estimate the prognosis of gastric cancer patients, but the 7th TNM system was simpler and easier to use.