Evaluation of the seventh AJCC TNM staging system for gastric cancer: a meta-analysis of cohort studies

Tumor Biology ◽  
2014 ◽  
Vol 35 (9) ◽  
pp. 8525-8532 ◽  
Author(s):  
Jizhun Zhang ◽  
Yangbing Zhou ◽  
Kewei Jiang ◽  
Zhanlong Shen ◽  
Yingjiang Ye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System

scholarly journals Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study

2019 ◽  
Vol 44 (1) ◽  
pp. 213-222
Author(s):  
Lin-Yong Zhao ◽  
Yong-Liang Zhao ◽  
Jun-Jiang Wang ◽  
Qi-Di Zhao ◽  
Wen-Qi Yi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Plasma Fibrinogen ◽  
Tnm Staging System ◽  
N Stage ◽  
Gastric Cancer Patients

Abstract Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

scholarly journals A nomogram based on Aspartate Aminotransferase/Alanine Aminotransferase (AST/ALT) ratio after surgery to predict the prognostic value in patients with gastric cancer

2020 ◽  
Author(s):  
Linfang Li ◽  
Shan Xing ◽  
Ning Xue ◽  
Miantao Wu ◽  
Yaqing Liang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Cox Regression ◽  
Staging System ◽  
Tnm Staging ◽  
Calibration Plot ◽  
Study Cohort ◽  
Tnm Staging System ◽  
Resectable Gastric Cancer

Abstract Background This study aimed to develop an effective nomogram for predicting overall survival (OS) in surgically treated gastric cancer. Methods We retrospectively evaluated 190 gastric cancer in this study. Cox regression analyses were performed to identify significant prognostic factors for OS in patients with resectable gastric cancer. The predictive accuracy of nomogram was assessed by calibration plot, concordance index (C-index) and decision curve, and then were compared with the traditional TNM staging system. Based on the total points (TPS) by nomogram, we further divided patients into different risk groups. Results On multivariate analysis of the 190 cohort, independent factors for survival were age, clinical stage and Aspartate Aminotransferase/Alanine Aminotransferase (SLR), which were entered into the nomogram. The calibration curve for the probability of OS showed that the nomogram-based predictions were in good agreement with actual observations. And the C-index of the established nomogram for predicting OS had a superior discrimination power compared with the TNM staging system [0.768 (95% CI: 0.725-0.810) vs 0.730 (95% CI: 0.688-0.772), p < 0.05]. Decision curve also demonstrated that the nomogram was better than TNM staging system. Based on the TPS of the nomogram, we further subdivided the study cohort into 3 groups: low risk (TPS ≤ 158), middle risk (158 < TPS ≤ 188), high risk (TPS > 188), the differences of OS rate were significant in the groups. Conclusions The established nomogram resulted in more accurate prognostic prediction for individual patient with resectable gastric cancer.

Prognostic value of subclassification of pT2 stage in patients with gastric cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16070-e16070
Author(s):  
Kang He ◽  
Xiaohua Wang ◽  
Cheng Chen ◽  
Yingying Jiang ◽  
Yue Shi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Tumor Invasion ◽  
Radical Surgery ◽  
Muscularis Propria ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System ◽  
Pn Stage ◽  
Better Than

e16070 Background: The data about prognosis difference of patients with pT2 stage gastric cancer (GC) after radical surgery is diverse. The latest TNM staging system does not define details for the pT2 stage subclassification. The purpose of this study is to investigate the survival difference according to depth of tumor muscularis propria involvement and find biomarker to reinforce the prognostic and therapy-guided ability of TNM staging system. Methods: A total of 380 patients with pT2 GC after radical surgery were retrospectively analyzed, including 185 in sMP (superficial muscularis propria) group and 195 in dMP (deep muscularis propria) group. The log-rank test was used to identify survival outcomes. Independent factors were identified by multivariable Cox proportional hazard model for OS. Results: The overall survival (OS) of patients in sMP group was significantly better than patients in dMP group (P = 0.007). On multivariate analysis, age (＜60 vs ≥60: P = 0.004, HR, 2.075(95%CI: 1.261-3.414)), primary location (P = 0.002, U vs M: 0.985(0.509-1.909); U vs L: 0.400(0.235-0.680)), depth of tumor invasion (sMP vs dMP: P = 0.050, 1.584(1.261-3.414), pN stage (P = 0.000, N0 vs N1: 2.304(1.364-3.890); N0 vs N2: 1.879(0.967-3.652); N0 vs N3: 5.335(2.533-11.237)), expression of p53 (negative vs positive: P = 0.016, 1.793(1.117-2.879)) were independent prognostic factors for the OS. In pN0 stage tumor, the sMP group had a significantly better OS than the dMP group (P = 0.014). When classified as N+, there was no obviously difference of OS between two groups (P = 0.384). When patients were stratified according to the depth of tumor invasion and pN stage, the OS was not significant difference between dMPN0 group and sMPN1-2 group (P = 0.100), the OS of patients with adjuvant chemotherapy were statistically better than those without in dMPN0 group (P = 0.045), but not significance in sMPN1-2 group (P = 0.486). After further grouping according to adjuvant chemotherapy status, in comparison to sMPN1-2 patients, dMPN0 patients with adjuvant chemotherapy had better OS (P = 0.015), but not significance in patients without (P = 0.599). Upon stratification according to the expression of p53, in p53-positive group, greater OS could be observed in patients with sMPN0 than patients with dMPN0 (P = 0.002). Similar OS could be seen between dMPN0 patients with p53-positive and T2N1-2 patients (P = 0.872). Conclusions: For pT2 gastric cancer patients, there were differences in survival outcomes for sMP and dMP invasion. The prognosis of dMPN0 patients were similar to patients with sMPN1-2, and dMPN0 patients who accepted adjuvant chemotherapy had an improved prognosis than those without. Appropriate adjuvant chemotherapy should be considered for patients with dMPN0 stage. In addition, positive expression of p53 could be potential factors to identify the different prognoses for patients with pT2 gastric cancers.

scholarly journals Gastric Stump Cancer: More Than Just Another Proximal Gastric Cancer and Demanding a More Suitable TNM Staging System

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
André Costa-Pinho ◽  
J. Pinto-de-Sousa ◽  
José Barbosa ◽  
J. Costa-Maia
Keyword(s):  
Gastric Cancer ◽  
Staging System ◽  
Median Number ◽  
Tnm Staging ◽  
Biological Behavior ◽  
Gastric Stump ◽  
Proximal Gastric Cancer ◽  
Gastric Stump Cancer ◽  
Cumulative Survival ◽  
Tnm Staging System

Background. Considerable controversy persists about the biological behavior of gastric stump cancer (GSC). The aim of this study is to clarify if this cancer is just another proximal gastric cancer or if it emerges as a distinctive clinicopathologic entity.Methods. This review of a prospectively collected gastric cancer database identified 73 patients with GSC in a single institution between January 1980 and June 2012 and compared them with 328 patients with proximal gastric cancer (PGC) and 291 patients with esophagogastric junction cancer (EGJC).Results. Patients with GSC were predominantly males. Eighty-three percent of GSC penetrated the subserosal or the serosal layers. The median number of lymph nodes retrieved in GSC patients was significantly lower than in PGC patients or in EGJC patients. Cumulative survival curves were not different between GSC, PGC, or EGJC patients. Unlike that observed in PGC and in EGJC, no significant differences in cumulative survival according to the TNM staging system were observed in GSC cases.Conclusions. The outcome of patients with GSC displayed significant differences when compared to those with other proximal gastric cancers concerning the lack of survival association with the TNM staging system. Therefore a more suitable staging system should be designed for these unique cancers.

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