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dc.contributor.authorWang, Jiping
dc.contributor.authorDang, Ping
dc.contributor.authorRaut, Chandrajit P
dc.contributor.authorPandalai, Prakash K.
dc.contributor.authorMaduekwe, Ugwuji N.
dc.contributor.authorRattner, David William
dc.contributor.authorLauwers, Gregory Y.
dc.contributor.authorYoon, Sam
dc.date.accessioned2018-03-26T17:40:10Z
dc.date.issued2012
dc.identifier.citationWang, Jiping, Ping Dang, Chandrajit P. Raut, Prakash K. Pandalai, Ugwuji N. Maduekwe, David W. Rattner, Gregory Y. Lauwers, and Sam S. Yoon. 2012. “Comparison of a Lymph Node Ratio–Based Staging System With the 7th AJCC System for Gastric Cancer.” Annals of Surgery 255 (3): 478–485. doi:10.1097/sla.0b013e31824857e2.en_US
dc.identifier.issn0003-4932en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:35136027
dc.description.abstractOBJECTIVES: The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. METHODS: A total of 18,043 gastric cancer patients who underwent gastrectomy were identified from the US Surveillance, Epidemiology, and End Results (SEER) database. A training set was divided into 5 Nr groups, and a TNrM staging system was constructed. Median survival and overall survival, based on 7th edition AJCC and TNrM staging systems, were compared, and the analysis was repeated in a validation set. RESULTS: Median examined nodes were 10 to 11. For the training set, overall survival for all 5 AJCC N categories was significantly different when subgrouped into 15 or fewer versus more than 15 examined nodes, but overall survival was similar regardless of the number of examined nodes in 4 of 5 Nr categories. Seven AJCC stages had statistically different overall survival between subgroups, whereas only 1 TNrM stage had statistically different overall survival between subgroups. When misclassification was defined as any subgroup in which median survival fell outside the 95% confidence interval of the group's overall median survival, AJCC staging misclassified 57% of patients and TNrM staging misclassified only 12%. Similar results were found in the validation set. CONCLUSIONS: The AJCC system classifies SEER gastric cancer patients into stages in which subgroups often have wide variations in survival. For patients undergoing limited lymph node analysis, the proposed TNrM system may predict survival more accurately.en_US
dc.language.isoen_USen_US
dc.publisherOvid Technologies (Wolters Kluwer Health)en_US
dc.relation.isversionofdoi:10.1097/SLA.0b013e31824857e2en_US
dash.licenseMETA_ONLY
dc.titleComparison of a Lymph Node Ratio–Based Staging System With the 7th AJCC System for Gastric Canceren_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalAnnals of Surgeryen_US
dash.depositing.authorLauwers, Gregory Y.
dash.embargo.until10000-01-01
dc.identifier.doi10.1097/SLA.0b013e31824857e2*
workflow.legacycommentsnoap.needmanen_US
dash.contributor.affiliatedYoon, Sam
dash.contributor.affiliatedWang, Jiping
dash.contributor.affiliatedRattner, David
dash.contributor.affiliatedLauwers, Gregory Y.
dash.contributor.affiliatedRaut, Chandrajit


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