RT Journal Article
SR Electronic
T1 Proposal of a Dukes-MAC-like staging system for gastric cancer
JF Journal of Investigative Medicine
JO J Investig Med
FD BMJ Publishing Group Ltd
SP 316
OP 322
DO 10.1136/jim-2016-000270
VO 65
IS 2
A1 Simona Gurzu
A1 Haruhiko Sugimura
A1 Janina Orlowska
A1 Janos Szederjesi
A1 Zoltan Szentirmay
A1 Tivadar Bara
A1 Tivadar Bara, Jr
A1 Ananmaria Fetyko
A1 Ioan Jung
YR 2017
UL http://hw-f5-jim.highwire.org/content/65/2/316.abstract
AB The aim of this study was to present an epidemiological update regarding the classical prognostic parameters of gastric cancer (GC) in 3 countries from Eastern Europe and to suggest a modification of the pTNM staging system. In 333 consecutive cases which were diagnosed between 2003 and 2012 in 3 departments of pathology from Romania, Hungary, and Poland, the following parameters were analyzed: age and gender of patients, tumor localization, macroscopic and microscopic aspects including the degree of discohesivity, depth of tumor infiltration, and pTNM stage. From all of the studied parameters, the following proved to have independent prognostic value, indicating a lower survival rate: presence of distant metastases (p=0.001), lymph node positivity (p=0.0009), depth of tumor infiltration (p=0.04), age over 50 (p=0.02), proximally located tumors (p=0.03), and ulceroinfiltrative or diffusely infiltrative macroscopic aspect (p=0.0002). The pT2N1-3 staged cases showed a worse prognosis compared with the pT3N0 ones (p=0.02). Regardless of depth of invasion, the lymph node status remains the strongest indicator of the survival rate in GC. The pTN staging system should be adapted and a Dukes-MAC-like staging system should include the following groups: stage A1—T1N0, stage A2—T1N1-3, stage B1—T2N0, stage B2—T2N1-3, stage C1—T3N0, stage C2—T3N1-3, and stage D—T4N0-3. The grade of discohesivity/budding is not a prognostic factor in GC.