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      Comparison of the Differences in Survival Rates between the 7th and 8th Editions of the AJCC TNM Staging System for Gastric Adenocarcinoma: a Single-Institution Study of 5,507 Patients in Korea

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          Abstract

          Purpose

          The aims of this study were to compare the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging manuals on tumor, node, and metastasis (TNM) staging systems and to evaluate whether the 8th edition represents a better refinement of the 7th staging system, when applied for the classification of gastric cancers.

          Materials and Methods

          A total of 5,507 gastric cancer patients, who underwent treatment from January 1989 to December 2013 at a single institute, were included. We compared patient survival rates across the disease groups classified according to the 7th and 8th editions of the AJCC TNM staging systems.

          Results

          Stage migration was observed in 6.4% (n=355) of the patients. Of these, 3.5% (n=192) and 2.9% (n=158) of patients showed a higher stage and lower stage, respectively. According to the 8th edition of the AJCC TNM staging criteria, the 5-year overall survival rates of the patients with stage IIIB and IIIC showed a significant difference (40.8% vs. 20.2%, P<0.001) whereas no significant differences in the 5-year overall survival rates were observed according to the 7th edition criteria (37.6% vs. 33.2%, P=0.381).

          Conclusions

          Restaging stage III cancers according to the 8th edition of the AJCC TNM classification criteria improved survival rate discrimination, particularly, in institutes where the stage III patients were not distinctly categorized.

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          Most cited references15

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          7th edition of the AJCC cancer staging manual: stomach.

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            Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association staging project.

            The current AJCC staging system for gastric cancer (AJCC7) incorporated several major revisions to the previous edition. The T and N categories and the stage groups were newly defined, and adenocarcinoma of the esophagogastric junction (EGJ) was reclassified and staged according to the esophageal system. Studies to validate these changes showed inconsistent results. The International Gastric Cancer Association (IGCA) launched a project to support evidence-based revisions to the next edition of the AJCC staging system.
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              Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2013

              Purpose: This study described the 2013 nationwide cancer statistics in Korea, including cancer incidence, survival, prevalence, and mortality. Materials and Methods: Cancer incidence data from 1999-2013 were obtained from Korea National Cancer Incidence Database and followed until December 31, 2014. Mortality data from 1983-2013 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2014 among all cancer patients diagnosed since 1999. Crude, and age-standardized and 5-year relative survival rates were also calculated. Results: In 2013, a total of 225,343 and 75,334 Koreans were newly diagnosed and died from cancer, respectively. The age-standardized rates for cancer incidence and mortality in 2013 were 290.5 and 87.9 per 100,000, respectively. The age-standardized cancer incidence rate increased 3.1% annually between 1999 and 2013. However, the overall cancer incidence rates have decreased slightly in recent years (2011 to 2013). The age-standardized rate for all-cancer mortality has decreased 2.7% annually since 2002. Overall, the 5-year relative survival rate for people diagnosed with cancer between 2009 and 2013 was 69.4%, which represents an improved survival rate as compared with 41.2% for people diagnosed between 1993 and 1995. Conclusion: Age-standardized cancer incidence rates have decreased between 2011 and 2013; mortality rates have also declined since 2002, while 5-year survival rates have improved remarkably from 1993-1995 to 2009-2013 in Korea.
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                Author and article information

                Journal
                J Gastric Cancer
                J Gastric Cancer
                JGC
                Journal of Gastric Cancer
                The Korean Gastric Cancer Association
                2093-582X
                2093-5641
                September 2017
                31 July 2017
                : 17
                : 3
                : 212-219
                Affiliations
                Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
                Author notes
                Correspondence to Cho Hyun Park. Division of Gastrointestinal Surgery, Department of General Surgery, The Catholic University of Korea School of Medicine, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel: +82-2-2258-2876, Fax: +82-2-595-2822, chpark@ 123456catholic.ac.kr
                Author information
                https://orcid.org/0000-0002-3087-9728
                Article
                10.5230/jgc.2017.17.e23
                5620090
                28970951
                25d0d8b5-03e3-4f90-b2e3-2c72394c82a0
                Copyright © 2017. Korean Gastric Cancer Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 May 2017
                : 07 July 2017
                : 07 July 2017
                Categories
                Original Article

                Oncology & Radiotherapy
                stomach neoplasms,8th edition,american joint committee on cancer,survival,prognosis

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