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Equipping the 8th Edition American Joint Committee on Cancer Staging for Gastric Cancer with the 15-Node Minimum: a Population-Based Study Using Recursive Partitioning Analysis

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机构: [1]Sun Yat Sen Univ, Dept Gastr Surg, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China; [2]Sun Yat Sen Univ, Dept Med Oncol, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China; [3]Lan Zhou Univ, Dept Gen Surg, Hosp 2, Lanzhou 730030, Gansu, Peoples R China
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关键词: Gastric cancer American Joint Committee on Cancer staging Evaluated lymph node Recursive partitioning analysis Surveillance Epidemiology and End Results

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Bakcground The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC. Methods We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets. Results For each 8th AJCC stage, survival was significantly better for patients with >= 15 ELNs versus those with <15 ELNs (P < 0.001 for all). RPA divided non-metastatic GC into seven stages: RPA-IA (8th AJCC IAwith >= 15 ELNs), RPA-IB (IAwith < 15 ELNs and IB/IIAwith >= 15 ELNs), RPA-IIA (IB with <15 ELNs and IIB with >= 15 ELNs), RPA-IIB (IIAwith <15 ELNs and IIIAwith >= 15 ELNs), RPA-IIIA (IIB with <15 ELNs), RPA-IIIB (IIIAwith <15 ELNs and IIIB >= 15 ELNs), and RPA-IIIC (IIIB with <15 ELNs and IIIC). The corresponding 5-year survival rates were 84.1, 70.3, 52.8, 41.4, 32.9, 21.7, and 10.2%, respectively (P < 0.001 for all pairwise comparisons). The RPA staging outperformed the 8th AJCC staging in terms of discrimination and homogeneity among the SEER training and validation sets, as well as an independent Chinese cohort. Conclusion By equipping the 8th AJCC stage with the 15-ELN threshold, the proposed RPA staging is superior to the 8th AJCC staging without overcomplicating.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学 3 区 外科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 外科 4 区 胃肠肝病学
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第一作者机构: [1]Sun Yat Sen Univ, Dept Gastr Surg, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China;
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通讯机构: [1]Sun Yat Sen Univ, Dept Gastr Surg, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, 651 Dong Feng Rd East, Guangzhou 510060, Guangdong, Peoples R China;
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