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Which Staging System Is More Suitable for Gastric Neuroendocrine Cancer and Mixed Adenoneuroendocrine Carcinomas? A Multicenter Cohort Study.

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机构: [1]Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [2]Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [3]Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. [4]Department of Gastrointestinal Surgery, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China. [5]Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China. [6]Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China. [7]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. [8]Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [9]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China. [10]Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China. [11]Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute, The Affiliated Hospital of Putian University, Putian, China. [12]Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China. [13]Department of General Surgery, Henan Cancer Hospital, Zhengzhou, China. [14]Department of Gastrointestinal Surgery, Fujian Medicine University Teaching Hospital, The First Hospital of PuTian, Putian, China. [15]Department of Gastrointestinal Surgery, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China. [16]Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China. [17]Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. [18]Department of Gastrointestinal Surgery, The Second People's Hospital of Liaocheng, Liaocheng, China. [19]Department of Gastrointestinal Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China. [20]Department of Gastroenterology Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China. [21]Department of Gastrointestinal Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. [22]Department of Gastrointestinal Surgery, Second Affiliated Hospital, Nanchang University, Nanchang, China. [23]Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. [24]Department of Gastrointestinal Surgery, Meizhou People's Hospital, Meizhou, China. [25]Department of General Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China. [26]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
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To evaluate whether the European Neuroendocrine Tumor Society (ENETS) system or the 8th American Joint Committee on Cancer (AJCC) staging manual are suitable for gastric neuroendocrine carcinomas and/or mixed adenoneuroendocrine carcinomas (G-NECs/MANECs).Patients in a multicentric series with G-NEC/MANEC who underwent curative-intent surgical resection for a primary tumor were included. An optimal staging system was proposed base on analysis of the T and N status and validated by the SEER database.Compared with the ENETS system, the survival curves of the T category and N category in the 8th AJCC system were better separated and distributed in a more balanced way, but the survival curves of T2 vs. T3, N0 vs. N1, and N3a vs. N3b overlapped. For the T category, the 8th AJCC T category was modified by combining T2 and T3, which was consistent with the T category in the 6th AJCC manual for GC. For the N category, the optimal cut-off values of metastatic lymph nodes using X-tile were also similar to those of the N category in the 6th AJCC system. The Kaplan-Meier plots of the 6th AJCC system showed statistically significant differences between individual substages. Compared with the other 2 classifications, the 6th AJCC system also showed superior prognostic stratification. Similar results were obtained in both multicentric and SEER validation sets.Compared to the 8th AJCC and ENETS systems, the 6th AJCC staging system for GC is more suitable for G-NEC/MANEC and can be adopted in clinical practice.© 2020 S. Karger AG, Basel.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢 2 区 神经科学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢 2 区 神经科学
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出版当年[2021]版:
Q2 NEUROSCIENCES Q2 ENDOCRINOLOGY & METABOLISM
最新[2023]版:
Q2 ENDOCRINOLOGY & METABOLISM Q2 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者:
第一作者机构: [1]Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [2]Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [3]Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
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通讯作者:
通讯机构: [1]Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [2]Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China. [3]Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. [*1]Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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