Ilhan Enver, Ureyen Orhan, Meral Ulvi Mehmet
Department of Surgery, Division A, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Surgery, Izmir Military Hospital, Izmir, Turkey.
Prz Gastroenterol. 2016;11(4):223-225. doi: 10.5114/pg.2016.64069. Epub 2016 Dec 7.
Because of different prognosis of gastric cancer patients with the same T and N stages, the impossibility of N3 staging in patients with fewer than 15 removed lymph nodes, and the presence of stage migration phenomenon, the 6 edition TNM Staging System for gastric cancer was updated to the 7 edition TNM staging system in 2009. Despite some opposing views, the superiority of the 7 edition TNM staging system compared to the 6 has been demonstrated in many studies. However, there are doubts about the 7 edition that it will reduce the stage migration phenomenon. The most important problem about the 7 TNM staging system is regarding subgroups N3a and N3b. The separation of N3 stage as N3a and N3b does not contribute to the TNM staging system. In conclusion, separate usage of N3a and N3b subgroups in the TNM staging system should be considered in the creation phase of the 8 edition.
由于相同T和N分期的胃癌患者预后不同、清扫淋巴结少于15枚的患者无法进行N3分期以及存在分期迁移现象，胃癌的第6版TNM分期系统于2009年更新为第7版TNM分期系统。尽管存在一些反对意见，但多项研究已证明第7版TNM分期系统相较于第6版具有优越性。然而，有人质疑第7版是否会减少分期迁移现象。第7版TNM分期系统最重要的问题在于N3a和N3b亚组。将N3期分为N3a和N3b对TNM分期系统并无帮助。总之，在第8版的制定阶段应考虑在TNM分期系统中单独使用N3a和N3b亚组。
