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Comparison of the Sixth and Seventh Editions of the AJCC TNM Classification for Gallbladder Cancer

 Tak Geun Oh  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Woo Jung Lee  ;  Kyung Sik Kim  ;  Gi Hong Choi  ;  Si Young Song  ;  Jae Bok Chung  ;  Seung Woo Park  ;  Seungmin Bang 
 Journal of Gastrointestinal Surgery, Vol.17(5) : 925-930, 2013 
Journal Title
 Journal of Gastrointestinal Surgery 
Issue Date
BACKGROUND: This study aimed to compare the seventh edition of the tumor node metastasis (TNM) staging system to the sixth edition to validate its usefulness in predicting prognosis for gallbladder cancer. METHODS: Gallbladder cancer patients were staged according to both the sixth and seventh editions of the American Joint Committee on Cancer (AJCC) staging system. RESULTS: A total of 142 patients underwent cholecystectomy for gallbladder cancer. According to the seventh edition, the survival time of N1 and N2 was different (P = 0.006), and the survival difference between N0 and N1 became significant after excluding cases with no lymph node dissection (P = 0.035). The -2 log likelihoods of the sixth and seventh edition TNM stages were 216.282 and 217.460, respectively, suggesting non-superiority of the seventh edition. Excluding cases with no lymph node dissection resulted in a lower -2 log likelihood score for both editions (sixth, 157.002; seventh, 158.758). CONCLUSIONS: Sufficient lymph node dissection allows better prognostic stratification by application of the AJCC staging system. Even though the new N stage of the seventh edition showed some improvement in predicting prognosis, the overall performance of the seventh edition was not much better than the sixth. Further improvement is needed in the gallbladder cancer staging system.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김경식(Kim, Kyung Sik) ; 박승우(Park, Seung Woo) ; 박정엽(Park, Jeong Youp) ; 방승민(Bang, Seung Min) ; 송시영(Song, Si Young) ; 오탁근(Oh, Tak Geun) ; 이우정(Lee, Woo Jung) ; 정문재(Chung, Moon Jae) ; 정재복(Chung, Jae Bock) ; 최기홍(Choi, Gi Hong)
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