Old and new TNM in carcinoma of the gastric antrum: analysis of our personal experience

• Published in: Journal of gastrointestinal surgery 2003-11, Vol.7 (7), p.912-916
• Main Authors: Del Rio, Paolo, Dell'Abate, Paolo, Soliani, Paolo, Arcuri, Maria Francesca, Tacci, Sara, Ziegler, Stefanie, Sianesi, Mario
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - pathology; Aged; Cancer; Classification; Female; Gastrectomy - methods; Humans; Male; Medical research; Neoplasm Staging; Pyloric Antrum; Retrospective Studies; Stomach Neoplasms - pathology; Survival Analysis
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-003-0039-3

Various tumor node metastasis (TNM) classifications have been proposed for staging of gastric carcinoma, including the fourth edition of the TNM classification and the Japanese Research Society for Gastric Cancer (JRSGC) system. In 1997 the fifth edition of TNM classification introduced the concept of the number of metastatic lymph nodes. We review our experience with staging gastric cancer in light of both the fourth and fifth editions of the TNM classification system. From January 1986 to December 1997, we performed subtotal resection in 193 patients with carcinoma of the gastric antrum. A total of 147 patients presented with criteria from the fifth TNM edition. We compared data from these patients with data from the fourth TNM edition. We analyzed 84 females and 63 males whose average age was 68.9 years. The average number of lymph nodes removed was 16.7. We used the Kaplan-Meier method to analyze survival. In accordance with the fourth TNM edition, we recorded 82 patients who were pN0, 36 who were pN1, and 29 who were pN2; according to the fifth edition, 82 patients were pN0, 33 were pN1, 17 were pN2, and 15 were pN3. Average follow-up was 26.7 months, and average survival was 56.9 months for N0 patients, 38.7 months for N1 patients, and 24.5 months for N2 patients staged according to the fourth edition. According to the fifth edition, survival was 39.3 months for N1 patients, 33.6 months for N2 patients, and 10.3 months for N3 patients. The survival curve was statistically different (P