Purpose: Our study aims to test the prognostic accuracy of the N parameter of the 7th TNM in a Western series of D1-gastrectomies for gastric cancer (GC). Methods: Retrospectively considering a series of 224 non-metastatic GC patients who underwent surgery with curative intent and limited lymphadenectomy, we analyzed 5-year overall survival (OS) related to pN status according to both TNM editions (pN6 and pN7) and to lymph node ratio (LNR; LNR0, 0%, LNR1, 1-19%; LNR2, > 20%). We stratified pN6- and pN7-related OS by LNR. Results: Both pN6 and pN7 were shown to significantly stratify different subsets of GC patients, but there was no significant difference between pN71 and pN72, nor between pN62 and pN63. A multivariate model specific for pN7 eliminated the N2 group, while the pN6 model maintained all 3 N groups with highly discriminating hazard ratios. LNR was able to further stratify one category of pN6 (N2) and two categories of pN7 (N1 and N2). Conclusions: The 7th TNM edition for GC does not seem to be superior to the 6th edition in evaluating the prognostic relevance of lymph-nodal status: in particular, it does not allow an accurate stratification of OS in patients with less than 6 positive lymph nodes.

Lymph node staging in gastric cancer : New criteria, old problems / S. Rausei, G. Dionigi, L. Ruspi, I. Proserpio, F. Galli, F. Tirotta, F. Frattini, F. Rovera, L. Boni, G. Pinotti, R. Dionigi. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - 11:suppl. 1(2013), pp. S90-S94. [10.1016/S1743-9191(13)60025-4]

Lymph node staging in gastric cancer : New criteria, old problems

G. Dionigi;L. Boni;
2013

Abstract

Purpose: Our study aims to test the prognostic accuracy of the N parameter of the 7th TNM in a Western series of D1-gastrectomies for gastric cancer (GC). Methods: Retrospectively considering a series of 224 non-metastatic GC patients who underwent surgery with curative intent and limited lymphadenectomy, we analyzed 5-year overall survival (OS) related to pN status according to both TNM editions (pN6 and pN7) and to lymph node ratio (LNR; LNR0, 0%, LNR1, 1-19%; LNR2, > 20%). We stratified pN6- and pN7-related OS by LNR. Results: Both pN6 and pN7 were shown to significantly stratify different subsets of GC patients, but there was no significant difference between pN71 and pN72, nor between pN62 and pN63. A multivariate model specific for pN7 eliminated the N2 group, while the pN6 model maintained all 3 N groups with highly discriminating hazard ratios. LNR was able to further stratify one category of pN6 (N2) and two categories of pN7 (N1 and N2). Conclusions: The 7th TNM edition for GC does not seem to be superior to the 6th edition in evaluating the prognostic relevance of lymph-nodal status: in particular, it does not allow an accurate stratification of OS in patients with less than 6 positive lymph nodes.
Gastric cancer; Lymph node staging
Settore MED/18 - Chirurgia Generale
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/880808
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