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Poster display session

4336 - The N stages for early gastric cancer should differ from those of advanced gastric cancer: Results based on the SEER database Running title: A new N category for early gastric cancer

Date

09 Sep 2017

Session

Poster display session

Topics

Gastric Cancer

Presenters

Jian-Xian Lin

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

J. Lin, H. Chang-Ming, C. Zheng, P. Li, J. Wang

Author affiliations

  • Department Of Gastric Surgery, Fujian Medical University Union Hospital, 350001 - Fuzhou/CN
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Resources

Abstract 4336

Background

The aim of this study was to establish an appropriate N staging system for early gastric cancer (EGC).

Methods

Data from 24,223 patients who underwent radical gastrectomy between 1988 and 2011 were retrieved from the National Cancer Institute’s Surveillance, Epidemiology, and End Result (SEER) database. The optimal cutoff value for the number of LNs was determined by the X-tile program. The overall survival (OS) based on eighth edition and new TNM staging systems were compared, and the analysis was repeated in an external validation set.

Results

In the same T category, the OS rates were significantly different in each N category for advanced gastric cancer (AGC). However, no significant differences were observed in OS between N1 and N2 cancers or between N3a and N3b cancers in cases of EGC. The X-tile program identified that the difference in survival was most significant when 6 metastatic LNs were present. The new staging system for EGC consisted of T1N0, T1N1’ (1-6 metastatic LNs) and T1N2’ (≥7 metastatic LNs). Compared with the eighth edition of the TNM staging system, the OS of patients in the T1N1’ stage was similar to that of patients with stage IIA disease, whereas the OS of patients in the T1N2’ stages was similar to that of patients with stage IIB disease (P 

Conclusions

The N category of the eighth edition of the AJCC TNM classification exhibits variation in the survival of patients with AGC. However, this classification remains associated with some stage migration in EGC and the proposed N category permits better prognostic prediction.

Clinical trial identification

Legal entity responsible for the study

Changming Huang

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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