COMPARISON BETWEEN THE JAPANESE GENERAL RULES AND THE TNM SYSTEM IN THE REGIONAL LYMPH-NODE CLASSIFICATION OF CARCINOMA OF THE COLON

BACKGROUND: Metastasis to regional lymph nodes from carcinoma of the c olon is an important prognostic factor. In the tumor, node, metastasis classification, node metastases are classified into four grades based on the number and distribution of metastatic nodes. In the Japanese G eneral Rules for Clinical and Pathological Studies on Cancers of the C olon, Rectum and Anus, node metastases are classified into four grades based solely on the distribution of metastatic nodes. STUDY DESIGN: B ased on the findings of node metastases in 152 patients with carcinoma of the colon obtained by the clearing method, the node classification s by the Japanese General Rules and tumor, node, metastasis classifica tions were compared. RESULTS: The case distribution by the Japanese Ge neral Rules grading was 38.2 percent in n(-), 30.3 percent in n(1)(+), 19.7 percent in n(2)(+), and 11.8 percent in n(3)(+) disease. In the tumor, node, metastasis classification, the distribution was 22.4 perc ent in pN1 and pN3 and 17.1 percent in pN2 disease. The five-year surv ival rate by the Japanese General Rules was 97.9 percent in n(-), 72.6 percent in n(1)(+), 51.2 percent in n(2)(+), and 30.0 percent in n(3) (+) disease, whereas in tumor, node, metastasis classification, this r ate was 79.4 percent in pN1, 45.2 percent in pN2, and 44.8 percent in pN3 disease. CONCLUSIONS: In the classification of regional node metas tases from carcinoma of the colon, the Japanese General Rules showed a wider range in distribution and 5-year survival rate compared with th e tumor, node, metastasis system.