Shu Ping, Qin Jing, Shen Kuntang, Chen Weidong, Liu Fenglin, Fang Yong, Wang Xuefei, Wang Hongshan, Shen Zhenbin, Sun Yihong, Qin Xinyu
Department of General Surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
BMC Cancer. 2017 Mar 31;17(1):238. doi: 10.1186/s12885-017-3235-3.
A new staging system recently proposed by the IGCA has demonstrated a better capacity of 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.
Medical records of patients with gastric cancer who received curative surgery in our center 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.
One thousand five hundred twenty-six cases were included in this study. By comparing the AJCC7 system with the IGCA systems, 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 significant 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.
The IGCA staging system can stratify stage III gastric cancer patients more properly than the AJCC7 system.
国际胃癌协会（IGCA）最近提出的一种新分期系统在对胃癌不同预后进行分层方面，表现出比美国癌症联合委员会（AJCC）第7版分期系统（AJCC7）更好的能力。本研究的目的是评估IGCA系统在中国患者中的有效性。
回顾性分析2003年1月至2011年12月在本中心接受根治性手术的胃癌患者的病历。所有病变均根据AJCC7和IGCA分期系统进行分期。以患者的总生存期（OS）作为观察终点。
本研究纳入了1526例病例。通过比较AJCC7系统和IGCA系统，395例被分层到不同阶段，其中大多数处于III期。与AJCC7系统相比，IGCA系统能更好地对IIIB期和IIIC期患者进行分层（5年总生存率，38.1%对29.0%；P = 0.005），而AJCC7系统为（5年总生存率，38.2%对35.9%；P = 0.148）。T3N3bM0、T4aN2M0和T4aN3bM0占分期转移的97.5%（385/395）。在AJCC7系统中被分层为IIIB期的T3N3bM0，其预后明显比在同一系统中被分期为IIIB期和IIIC期的T4aN2M0和T4aN3aM0差。在IGCA分期系统中对不恰当的分期进行了修正。
与AJCC7系统相比，IGCA分期系统能更恰当地对III期胃癌患者进行分层。
