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Multi-institutional validation of the 8th AJCC TNM staging system for gastric cancer: Analysis of survival data from high-volume Eastern centers and the SEER database

 Taeil Son  ;  Jiyu Sun  ;  Seohee Choi  ;  Minah Cho  ;  In Gyu Kwon  ;  Hyoung‐Il Kim  ;  Jae‐Ho Cheong  ;  Seung Ho Choi  ;  Sung Hoon Noh  ;  Yanghee Woo  ;  Yuman Fong  ;  Sohee Park  ;  Woo Jin Hyung 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.120(4) : 676-684, 2019 
Journal Title
Issue Date
Adenocarcinoma/mortality ; Adenocarcinoma/pathology* ; Databases, Factual ; Female ; Follow-Up Studies ; Hospitals, High-Volume ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Predictive Value of Tests ; Prospective Studies ; Republic of Korea ; Retrospective Studies ; SEER Program ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Survival Rate
TNM ; staging ; stomach neoplasms
BACKGROUND: The clinical relevance and general applicability of the 8th American Joint Committee on Cancer TNM gastric cancer staging system vs the 7th version have not been examined using datasets from both the East and West. METHODS: Patients (n = 29 984) treated for gastric adenocarcinoma at two high-volume centers (Severance Hospital [SH] and Gangnam Severance Hospital [GSH]) in Korea and data from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Survival curves, the performance of tumor staging, and the homogeneity of modified subgroups were compared. RESULTS: Minute changes were noted in the stage IIB subgroup; most changes were noted in stage III. Applying the 8th staging system facilitated better prediction of survival than applying the 7th version for SH data according to the log-rank test, C-index, and AIC (8444.5 vs 9263.8, 0.796 vs 0.798, and 104152 vs 103909, respectively). Its performance was also superior for GSH and SEER data. In a subgroup analysis of stages IIB to IIIC in SH, GSH, and SEER data, the 8th staging system showed similar or more homogeneous survival for each sub-classification than the 7th version. CONCLUSION: Compared with the 7th gastric cancer staging system, the newer version more accurately predicted prognosis and stratified subgroups more homogeneously.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kwon, In Gyu(권인규) ORCID logo https://orcid.org/0000-0002-1489-467X
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, So Hee(박소희) ORCID logo https://orcid.org/0000-0001-8513-5163
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Choi, Seo Hee(최서희) ORCID logo https://orcid.org/0000-0002-4083-6414
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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