Evaluation of the TNM classification of stomach cancer and proposal for its rational stage-grouping.

The present TNM Classification with the provisional stage-grouping for stomach cancer, which was adopted in 1978, was evaluated for compatibility in respect to survival by using 15,589 stomach cancer patients registered in Japan from 1969 to 1973. Adequacy and usefulness were shown in all categories of T, N, M, pT and pN, individually. Important irrationality in accordance with the TNM General Rules was recognized in both the provisional TNM and p.TNM stage-groupings. More adequate stage-grouping was searched for and is discussed according to the results of statistical analysis of the patients' survival and the principle of the TNM General Rules. New TNM and p.TNM stage-groupings were proposed as the best ones at present.