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Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System
BACKGROUND: To assess the clinical significance and prognostic impact of extranodal metastasis (EM) in gastric carcinoma and establish an optimal classification in the staging system. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1343 patients with gastric carcinoma who underwent surgical resection wer...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113802/ https://www.ncbi.nlm.nih.gov/pubmed/21695186 http://dx.doi.org/10.1371/journal.pone.0019557 |
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author | Wang, Wei Li, Yuanfang Zhang, Yu Yuan, Xiuhong Xu, Dazhi Guan, Yuanxiang Feng, Xingyu Chen, Yingbo Sun, Xiaowei Li, Wei Zhan, Youqing Zhou, Zhiwei |
author_facet | Wang, Wei Li, Yuanfang Zhang, Yu Yuan, Xiuhong Xu, Dazhi Guan, Yuanxiang Feng, Xingyu Chen, Yingbo Sun, Xiaowei Li, Wei Zhan, Youqing Zhou, Zhiwei |
author_sort | Wang, Wei |
collection | PubMed |
description | BACKGROUND: To assess the clinical significance and prognostic impact of extranodal metastasis (EM) in gastric carcinoma and establish an optimal classification in the staging system. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1343 patients with gastric carcinoma who underwent surgical resection were recruited to determine the frequency and prognostic significance of EMs. EMs were divided into two groups (EM1 and EM2) and then incorporated into the 7(th) edition UICC TNM staging system. EMs was detected in 179 (13.3%) of 1343 patients who underwent radical resection. Multivariate analysis identified EMs as an independent prognostic factor (HR = 1.412, 95%CI = 1.151–1.731, P<0.001). After curative operation, the overall survival rate were worse in patients with ≥3 cases of EM (EM2) than those with the number of 1 and 2 cases (EM1) (P<0.001). Survival of patients with EM1 was found almost comparable to that of N3 stage (P = 0.437). Survival of patients with EM2 showed similar to that of stage IV patients (P = 0.896). By using the linear trend X(2), likelihood ratio X(2), and Akaike information criterion (AIC) test, EM1 treated as N3 stage and EM2 treated as M1 stage performed higher linear trend X(2) scores, likelihood ratio X(2) scores, and lower AIC value than the 7(th) edition UICC TNM staging system, which represented the optimum prognostic stratification, together with better homogeneity, discriminatory ability, and monotonicity of gradients. CONCLUSIONS/SIGNIFICANCE: EMs might be classified based on their number and prognostic information and should incorporate into the TNM staging system. |
format | Online Article Text |
id | pubmed-3113802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-31138022011-06-21 Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System Wang, Wei Li, Yuanfang Zhang, Yu Yuan, Xiuhong Xu, Dazhi Guan, Yuanxiang Feng, Xingyu Chen, Yingbo Sun, Xiaowei Li, Wei Zhan, Youqing Zhou, Zhiwei PLoS One Research Article BACKGROUND: To assess the clinical significance and prognostic impact of extranodal metastasis (EM) in gastric carcinoma and establish an optimal classification in the staging system. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1343 patients with gastric carcinoma who underwent surgical resection were recruited to determine the frequency and prognostic significance of EMs. EMs were divided into two groups (EM1 and EM2) and then incorporated into the 7(th) edition UICC TNM staging system. EMs was detected in 179 (13.3%) of 1343 patients who underwent radical resection. Multivariate analysis identified EMs as an independent prognostic factor (HR = 1.412, 95%CI = 1.151–1.731, P<0.001). After curative operation, the overall survival rate were worse in patients with ≥3 cases of EM (EM2) than those with the number of 1 and 2 cases (EM1) (P<0.001). Survival of patients with EM1 was found almost comparable to that of N3 stage (P = 0.437). Survival of patients with EM2 showed similar to that of stage IV patients (P = 0.896). By using the linear trend X(2), likelihood ratio X(2), and Akaike information criterion (AIC) test, EM1 treated as N3 stage and EM2 treated as M1 stage performed higher linear trend X(2) scores, likelihood ratio X(2) scores, and lower AIC value than the 7(th) edition UICC TNM staging system, which represented the optimum prognostic stratification, together with better homogeneity, discriminatory ability, and monotonicity of gradients. CONCLUSIONS/SIGNIFICANCE: EMs might be classified based on their number and prognostic information and should incorporate into the TNM staging system. Public Library of Science 2011-06-13 /pmc/articles/PMC3113802/ /pubmed/21695186 http://dx.doi.org/10.1371/journal.pone.0019557 Text en Wang et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Wang, Wei Li, Yuanfang Zhang, Yu Yuan, Xiuhong Xu, Dazhi Guan, Yuanxiang Feng, Xingyu Chen, Yingbo Sun, Xiaowei Li, Wei Zhan, Youqing Zhou, Zhiwei Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title | Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title_full | Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title_fullStr | Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title_full_unstemmed | Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title_short | Incorporation of Extranodal Metastasis of Gastric Carcinoma into the 7th Edition UICC TNM Staging System |
title_sort | incorporation of extranodal metastasis of gastric carcinoma into the 7th edition uicc tnm staging system |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113802/ https://www.ncbi.nlm.nih.gov/pubmed/21695186 http://dx.doi.org/10.1371/journal.pone.0019557 |
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