• Jizhun Zhang, Zhaojian Niu, Yanbing Zhou, and Shougen Cao.
• Department of General Surgery, Affiliated Hospital to Medical College of Qingdao University, Qingdao, China.
• Ann. Surg.. 2013 Jan 1;257(1):81-6.

ObjectiveTo evaluate the prognostic significance of the seventh edition TNM staging classification for gastric cancer.BackgroundThe seventh edition TNM staging system for gastric cancer was adopted by the American Joint Committee on Cancer/International Union Against Cancer on January 1, 2010, and included major revisions.MethodsThe authors analyzed data retrospectively collected on patients with gastric cancer who underwent surgery at the Affiliated Hospital of Qingdao University Medical College between 2000 and 2008. A total of 964 patients with gastric cancer who underwent R0 surgical resection were included.ResultsThe relative risk (RR) for the seventh edition T classification was found to increase steadily and reasonably compared with the sixth edition. However, the RR for the sixth edition N classification was found to increase steadily and reasonably compared with the seventh edition classification. Cox regression multivariate analysis showed that the sixth edition N classification was superior to the seventh edition N classification as an independent prognostic factor. In survival analysis, the seventh edition TNM classification provided a more detailed classification; however, some subgroups of the seventh edition TNM classification did not demonstrate significantly different survival rates. The combination of the seventh edition T classification and the sixth edition N classification, with ideal RR results, showed significantly different survival rates except for IA and IB.ConclusionsThe combination of the seventh edition T classification and the sixth edition N classification seems to provide the optimal prognosis.

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