A comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage in gastric carcinoma

BACKGROUND/AIMS: To clarify what staging system of lymph node metastasis is suitable for evaluating prognosis of gastric cancer patients. METHODOLOGY: We analyzed the survival 5 years after operation of 186 advanc ed gastric cancer patients who underwent potentially curative gastric resec tion. The following 3 systems were compared using multivariate analyses by the logistic regression model. Nodal status in pathology was classified as follows: (a) nodal stage according to the General Rules for the Gastric Can cer Study of the Japanese Research Society for Gastric Cancer (the Japanese Rules), (b) number of metastatic nodes according to the new UICC staging s ystem (the TNM system), (c) number of metastatic nodes in nl group of the J apanese. Rules (the new classification). RESULTS: The TNM system revealed better results than the nodal stage in sen sitivity and -2 log likelihood. The new classification revealed the best re sult among the 3 systems in sensitivity, specificity, accuracy and -2 log l ikelihood. CONCLUSIONS: The TNM system is a better prognostic factor than the nodal st age in the Japanese Rules, and the new classification is the best prognosti c factor of the above 3 systems in potentially curative advanced gastric ca ncer patients. Furthermore, the new classification might be useful in compa ring data between some facilities.