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Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer

BACKGROUND: Both surgical TNM (sTNM) and pathological TNM (pTNM) staging are important clinicopathologic indexes of gastric cancer (GC). However, surgeons and pathologists might assess tumor depth differently in the same patient. To investigate the prognostic significance of sTNM status in patients...

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Autores principales: Wang, Hong-Hu, Li, Kai, Xu, Hao, Sun, Zhe, Wang, Zhen-Ning, Xu, Hui-Mian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542286/
https://www.ncbi.nlm.nih.gov/pubmed/28148895
http://dx.doi.org/10.18632/oncotarget.14828
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author Wang, Hong-Hu
Li, Kai
Xu, Hao
Sun, Zhe
Wang, Zhen-Ning
Xu, Hui-Mian
author_facet Wang, Hong-Hu
Li, Kai
Xu, Hao
Sun, Zhe
Wang, Zhen-Ning
Xu, Hui-Mian
author_sort Wang, Hong-Hu
collection PubMed
description BACKGROUND: Both surgical TNM (sTNM) and pathological TNM (pTNM) staging are important clinicopathologic indexes of gastric cancer (GC). However, surgeons and pathologists might assess tumor depth differently in the same patient. To investigate the prognostic significance of sTNM status in patients with radically resected stage pT3-pT4b GC, we examined the relationship between sTNM and pTNM. METHODS: Clinicopathologic and survival data of 1289 patients with stage pT3-pT4b GC were studied retrospectively, in the aftermath of radical surgery. RESULTS: The unconformity for assessing tumor invasion depth were frequently exhibited between sT and pT staging. Comparison of 5-year OS among them, no significant differences were observed (pT3/sT3 vs pT3/sT4a, p=0.962; pT4a/sT4b vs pT4b/sT4b, p=0.508). Also, pT3/sT4b, pT4a/sT3 and pT4a/sT4a were homogeneity in prognosis. We proposed a revised pT stage in which surgical macroscopic T4b (sT4b) was incorporated into the pT stage, namely, patients in the pT3 stage with sT4b cancers were reclassified as being in the r-pT4a stage; patients in the pT4a stage with sT4b cancers were reclassified as being in the r-pT4b stage. In two-step multivariate analysis, revised pT stage proved more suitable for determining prognosis, surpassing both UICC/AJCC pT stage and sT stage as an independent prognostic index. CONCLUSIONS: Surgical T stage is a significant and independent prognostic index of overall survival (OS) in patients with radically resected advanced GC. Patients in the pT3/4a stage with sT4b cancers, are potentially underestimated, and should be considered higher stage in terms of prognostic.
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spelling pubmed-55422862017-08-07 Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer Wang, Hong-Hu Li, Kai Xu, Hao Sun, Zhe Wang, Zhen-Ning Xu, Hui-Mian Oncotarget Clinical Research Paper BACKGROUND: Both surgical TNM (sTNM) and pathological TNM (pTNM) staging are important clinicopathologic indexes of gastric cancer (GC). However, surgeons and pathologists might assess tumor depth differently in the same patient. To investigate the prognostic significance of sTNM status in patients with radically resected stage pT3-pT4b GC, we examined the relationship between sTNM and pTNM. METHODS: Clinicopathologic and survival data of 1289 patients with stage pT3-pT4b GC were studied retrospectively, in the aftermath of radical surgery. RESULTS: The unconformity for assessing tumor invasion depth were frequently exhibited between sT and pT staging. Comparison of 5-year OS among them, no significant differences were observed (pT3/sT3 vs pT3/sT4a, p=0.962; pT4a/sT4b vs pT4b/sT4b, p=0.508). Also, pT3/sT4b, pT4a/sT3 and pT4a/sT4a were homogeneity in prognosis. We proposed a revised pT stage in which surgical macroscopic T4b (sT4b) was incorporated into the pT stage, namely, patients in the pT3 stage with sT4b cancers were reclassified as being in the r-pT4a stage; patients in the pT4a stage with sT4b cancers were reclassified as being in the r-pT4b stage. In two-step multivariate analysis, revised pT stage proved more suitable for determining prognosis, surpassing both UICC/AJCC pT stage and sT stage as an independent prognostic index. CONCLUSIONS: Surgical T stage is a significant and independent prognostic index of overall survival (OS) in patients with radically resected advanced GC. Patients in the pT3/4a stage with sT4b cancers, are potentially underestimated, and should be considered higher stage in terms of prognostic. Impact Journals LLC 2017-01-26 /pmc/articles/PMC5542286/ /pubmed/28148895 http://dx.doi.org/10.18632/oncotarget.14828 Text en Copyright: © 2017 Wang et al. http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) (CC-BY), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Clinical Research Paper
Wang, Hong-Hu
Li, Kai
Xu, Hao
Sun, Zhe
Wang, Zhen-Ning
Xu, Hui-Mian
Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title_full Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title_fullStr Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title_full_unstemmed Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title_short Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer
title_sort improvement of t stage precision by integration of surgical and pathological staging in radically resected stage pt3-pt4b gastric cancer
topic Clinical Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542286/
https://www.ncbi.nlm.nih.gov/pubmed/28148895
http://dx.doi.org/10.18632/oncotarget.14828
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