Evidence map›Paper›PMID 28948368›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2018

The newly proposed clinical and post-neoadjuvant treatment staging classifications for gastric adenocarcinoma for the American Joint Committee on Cancer (AJCC) staging.

Haejin In, Ethan Ravetch, Marisa Langdon-Embry, Bryan Palis, Jaffer A Ajani, Wayne L Hofstetter, David P Kelsen, Takeshi Sano

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Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

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37citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed.

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  7. A novel ypN-TRG staging system for gastric cancer patients after neoadjuvant therapy based on the metro-ticket paradigm: a multicenter and large sample retrospective analysis.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Haejin InDepartment of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Ave. Block Building#112, Bronx, NY, 10461, USA. hin@montefiore.org.ORCID http://orcid.org/0000-0003-3267-6585
Ethan RavetchDepartment of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Ave. Block Building#112, Bronx, NY, 10461, USA.
Marisa Langdon-EmbryDepartment of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Ave. Block Building#112, Bronx, NY, 10461, USA.
Bryan PalisNCDB Research Unit, American College of Surgeons, Chicago, IL, USA.
Jaffer A AjaniDepartment of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Wayne L HofstetterDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
David P KelsenDepartment of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Takeshi SanoGastroenterological Center, Cancer Institute Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNew stage grouping classifications for clinical (cStage) and post-neoadjuvant treatment (ypStage) stage for gastric adenocarcinoma have been proposed for the eighth edition of the AJCC manual. This article summarizes the analysis for these stages.

methodsGastric adenocarcinoma patients diagnosed in 2004-2009 were identified from the National Cancer Database (NCDB). The cStage cohort included both surgical and nonsurgical cases, and the ypStage cohort included only patients who had chemotherapy or radiation therapy before surgery. Survival differences between the stage groups were determined by the log-rank test and prognostic accuracy was assessed by concordance index. Analysis was performed using SAS 9.4 (SAS, Cary, NC, USA).

resultsFive strata for cStage and four strata for ypStage were developed. The 5-year survival rates for cStages were 56.77%, 47.39%, 33.1%, 25.9%, and 5.0% for stages I, IIa, IIb, III, and IV, respectively, and the rates for ypStage were 74.2%, 46.3%, 19.2%, and 11.6% for stages I, II, III, and IV, respectively. The log-rank test showed that survival differences were well stratified and stage groupings were ordered and distinct (p < 0.0001). The proposed cStage and ypStage classification was sensitive and specific and had high prognostic accuracy (cStage: c index = 0.81, 95% CI, 0.79-0.83; ypStage: c index = 0.80, 95% CI, 0.73-0.87).

conclusionThe proposed eighth edition establishes two new staging schemata that provide essential prognostic data for patients before treatment and for patients who have undergone surgery following neoadjuvant therapy. These additions are a significant advance to the AJCC staging manual and will provide critical guidance to clinicians in making informed decisions throughout the treatment course.

Indexed as

AdenocarcinomaAdultAgedFemaleHumansMaleMiddle AgedNeoadjuvant TherapyNeoplasm StagingStomach NeoplasmsAJCCClinical stage (cStage)Gastric adenocarcinomaPost-neoadjuvant treatment stage (ypStage)Staging

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PMID28948368

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.