Han Liang, Xishan Hao, Rupeng Zhang, Dan Sun, Li Zhang, Xuejun Wang, Yong Liu
Objectives:
To elucidate the prognostic predication superiority of the seventh edition of the TNM classification for gastric cancer can be improved by combining the number of negative nodes.
Methods:
Clinicopathological data of 769 gastric cancer patients who underwent the curative gastrectomy plus lymphadenectomy between 1997 and 2007 were statistically analyzed for demonstrating the superiority of prognostic efficiency of the seventh edition of the TNM classification which could be improved by combination the number of negative nodes.
Results:
With the Cox regression multivariate analysis, the seventh edition of the TNM classification, the number of negative nodes, type of gastrectomy, and depth of tumor invasion (T stage) were identified as the independent factors for predication overall survival (OS) of gastric cancer patients. Furthermore, we validated the T stage-N stage-number of negative lymph nodes-metastasis (TNnM) classification should be deemed as the most appropriately prognostic predicators of gastric cancer patients by using the case-control matched fashion and multinominal logistic regression. Finally, we elucidated TNnM classification might provide the more precise survival differences among the different TNM sub-stages of gastric cancer patients with the Measure of agree Kappa value, McNemar value, the Akaike Information Criterion and the Bayesian Information Criterion, compared to the seventh edition of the TNM classification.
Conclusions:
The number of negative nodes, as an important prognostic predicator of gastric cancer, could improve the prognostic predication efficiency of the seventh edition of the TNM classification for gastric cancer, which should be recommended for conventionally clinical application.
