ArticleJournal of gastric cancer2018
Modification of the TNM Staging System for Stage II/III Gastric Cancer Based on a Prognostic Single Patient Classifier Algorithm.
Article in Journal of gastric cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 15 citations in OpenAlex.
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- The Current Evidence and Future Direction of Adjuvant Treatment for Gastric Cancer in the Era of Precision Medicine.Cancer research and treatment · 2025Review
- A pilot clinical study to evaluate feasibility of using single patient classifier as a prognostic test in stage IIChinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2024Article
- Single patient classifier as a prognostic biomarker in pT1N1 gastric cancer: Results from two large Korean cohorts.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2021Article
- Characterization and clinical evaluation of microsatellite instability and loss of heterozygosity in tumor-related genes in gastric cancer.Oncology letters · 2021Article
- Identifying four DNA methylation gene sites signature for predicting prognosis of osteosarcoma.Translational cancer research · 2020Article
- Chemokine receptor 4 expression is correlated with the occurrence and prognosis of gastric cancer.FEBS open bio · 2020Article
- Function of fibroblast growth factor 2 in gastric cancer occurrence and prognosis.Molecular medicine reports · 2020Article
- Clinical Implications of Microsatellite Instability in Early Gastric Cancer.Journal of gastric cancer · 2019Article
- Clinical Implementation of Precision Medicine in Gastric Cancer.Journal of gastric cancer · 2019Review
- Ten Thousand Consecutive Gastrectomies for Gastric Cancer: Perspectives of a Master Surgeon.Yonsei medical journal · 2019Review
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10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. MATERIALS AND
methodsWe previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical.
resultsAmong the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001).
conclusionsThe pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.
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