Abstract
Background: The definition of the degree of lymph node metastasis (n-classification) for gastric
cancer differs greatly in the new Union Internationale Contre le Cancer—TNM classification
(5th edition) and the Japanese gastric cancer classification (JGC). The feasibility
of the new TNM classification is evaluated in comparison with the JGC. Methods: At Chiba University, 940 patients who underwent a gastrectomy were retrospectively
classified into appropriate stages with both the TNM and JGC systems, and the survival
curves of the respective stages were also compared. Results: Patients with 1 to 6 metastatic nodes (TNM-pN1) showed similar survival rates whether
the metastases were limited to the perigastric area (JGC-n1) or reached distant areas
(JGC-n2). The patients with node metastasis that was limited to the perigastric area
(JGC-n1) had significantly different survival rates, depending on the number of metastatic
nodes (TNM-pN1 or pN2, P =.022). A similar phenomenon was also observed in patients with TNM-N2 and JGC-n2.
A multivariate analysis indicated the TNM N-classification, rather than the JGC n-classification,
as an independent prognostic factor. Conclusions: The new TNM classification appears to be a better prognostic indicator than the JGC
system for patients with gastric carcinoma. (Surgery 2000;127:129-35.)
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Article info
Publication history
Accepted:
August 12,
1999
Footnotes
*Reprint requests: Hideki Hayashi, MD, Department of Surgery, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
