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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cancer 1/2017

The IGCA staging system is more accurate than AJCC7 system in stratifying survival of patients with gastric cancer in stage III

Zeitschrift:
BMC Cancer > Ausgabe 1/2017
Autoren:
Ping Shu, Jing Qin, Kuntang Shen, Weidong Chen, Fenglin Liu, Yong Fang, Xuefei Wang, Hongshan Wang, Zhenbin Shen, Yihong Sun, Xinyu Qin
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12885-017-3235-3) contains supplementary material, which is available to authorized users.

Abstract

Background

A new staging system recently proposed by the IGCA has demonstrated a better capacity of stratifying different prognoses for gastric cancer than the 7th edition AJCC staging system (AJCC7). The aim of this study was to evaluate the efficacy of the IGCA system in Chinese patients.

Methods

Medical records of patients with gastric cancer who received curative surgery in our center from January 2003 to December 2011 were reviewed retrospectively. All the lesions were staged according to both AJCC7 and IGCA staging systems. Overall survival (OS) of the patients was used as the observation endpoint.

Results

One thousand five hundred twenty-six cases were included in this study. By comparing the AJCC7 system with the IGCA systems, 395 cases were stratified into different stages, most of which were in stage III. The IGCA system could better stratify stage IIIB and IIIC patients (5-year OS, 38.1% vs. 29.0%; P = 0.005) than the AJCC7 system (5-year OS, 38.2% vs. 35.9%; P = 0.148). T3N3bM0, T4aN2M0 and T4aN3bM0 made up 97.5% (385/395) of the stage shift. T3N3bM0, which was stratified to stage IIIB in the AJCC7 system, showed a significant poorer prognosis than T4aN2M0 and T4aN3aM0, which were staged to IIIB and IIIC in the same system. The improper staging was revised in the IGCA staging system.

Conclusions

The IGCA staging system can stratify stage III gastric cancer patients more properly than the AJCC7 system.
Zusatzmaterial
Additional file 1: Figure: S1. The survival distributions of 332 patients who received adjuvant chemotherapy in our own center. a The survival distributions of different stages Grouped by AJCC7 staging system. It was unable to distinguish the OS difference between III B and III C diseases (P = 0.958); b The survival distributions of different stages Grouped by IGCA staging system. The survival of III B and III C diseases were perfectly stratified (P = 0.003). (TIFF 5298 kb)
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Literatur
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