12 The igca staging system compared with ajcc7 system in stratifying survival of patients with cancer

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Abstract

Objectives

A new staging system recently proposed by the IGCA has demonstrated a better capacity for stratifying different prognoses for gastric cancer than the 7th edition AJCC staging system (AJCC7). The aim of this study was to evaluate the efficacy of the IGCA system in Chinese patients.

Methods

Medical records of patients with gastric cancer who received curative surgery in our centre from January 2003 to December 2011 were reviewed retrospectively. All the lesions were staged according to both AJCC7 and IGCA staging systems. Overall survival (OS) of the patients was used as the observation endpoint.

Results

One thousand five hundred and twenty-six cases were included in this study. By comparing the AJCC7 system with the IGCA system, 395 cases were stratified into different stages, most of which were in stage III. The IGCA system could better stratify stage IIIB and IIIC patients (5-year OS, 38.1% vs. 29.0%; p=0.005) than the AJCC7 system (5-year OS, 38.2% vs. 35.9%; p=0.148). T3N3bM0, T4aN2M0 and T4aN3bM0 made up 97.5% (385/395) of the stage shift. T3N3bM0, which was stratified to stage IIIB in the AJCC7 system, showed a significantly poorer prognosis than T4aN2M0 and T4aN3aM0, which were staged to IIIB and IIIC in the same system. The improper staging was revised in the IGCA staging system.

Conclusions

The IGCA staging system can stratify stage III gastric cancer patients more correctly than the AJCC7 system.

Acknowledgement

Supported by the National Natural Science Foundation of China (Grant No. 14B520013) and the Scientific Research Project from the open fund of Henan Key laboratory (Grant No. 172400410344).

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