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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 329 - 343 (15page)
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Purpose: Gastric cancer with lymph node metastasis (LNM) more than 15 (N3b) was definedas stage IV until the 6th AJCC system. However, it has been reclassified as a localized disease(stage IIb or III) since the 7th system. The aim of this study is to demonstrate that thesurvival of N3b is comparable to cytology-only positive (CY1-only) stage IV and to proposea new TNM system interpreting N3b as an eligibility criterion for receiving more intensivechemotherapy regimens. Materials and Methods: 1,430 patients who underwent gastric cancer surgery at SeoulNational University Hospital from 2007 to 2012 were retrospectively analyzed. The 5-yearsurvival rate (5YSR) and 3-year recurrence-free survival (RFS) were evaluated according tothe 7th and 8th systems, as well as a new categorization based on N-classification; N0-2(LNM<7), N3a (LNM 7–15), or N3b (LNM>15). Results: The survival of N3b is comparable to that of CY1-only stage IV (log rank test,P=0.671) and is distinct from that of grossly stage IV (log rank test, P<0.001). The survivalof the remaining stage IIIc (T4bN3a) was comparable to those of N3b and CY1-only stage IV. Most N3b patients had significantly shorter 3-year RFS and mean RFS than those with IIb–IIIc, as if N3b itself was a higher TNM stage. Conclusions: In terms of survival, T4bN3a, N3b, and CY1-only stage IV were unified as stageIVa, while grossly stage IV was defined as stage IVb. N3b can be regarded as an eligibilitycriterion for undergoing more intensive chemotherapy regimens.
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참고문헌 (25)
참고문헌 신청
Edge SB / 2010 / The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM / Ann Surg Oncol 17:1471~1474
Greene FL / 2002 / The American Joint Committee on Cancer: updating the strategies in cancer staging / Bull Am Coll Surg 87:13~15
Ahn HS / 2010 / Evaluation of the seventh American Joint Committee on Cancer/International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classification / Cancer 116:5592~5598
Yeh CN / 2015 / N3 subclassification incorporated into the final pathologic staging of gastric cancer: a modified system based on current AJCC staging / Medicine (Baltimore) 94:e575
Sung Hoo Kim / 2011 / Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification / Journal of Gastric Cancer 11(2):94~100
Greene FL / 2002 / The American Joint Committee on Cancer: updating the strategies in cancer staging / Bull Am Coll Surg 87:13~15
Ahn HS / 2010 / Evaluation of the seventh American Joint Committee on Cancer/International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classification / Cancer 116:5592~5598
Yeh CN / 2015 / N3 subclassification incorporated into the final pathologic staging of gastric cancer: a modified system based on current AJCC staging / Medicine (Baltimore) 94:e575
Sung Hoo Kim / 2011 / Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification / Journal of Gastric Cancer 11(2):94~100
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