Comparison of prognostic scoring system to tumor node metastases 1992 and 1997 staging systems in gastric cancer patients

Tumor node metastases staging systems have been widely utilized to predict the prognosis of gastric cancer patients. The current study aimed to compare a prognostic scoring system to tumor node metastases 1992 and 1997 staging systems in predicting the outcome of resectable gastric cancer patients. Patients treated between 1996-1998 were retrospectively evaluated. Tumor depth in the gastric wall, anatomical location and number of metastatic lymph nodes, metastatic to retrieved lymph node ratio, extent of surgical resection, tumor location, type of lymph node dissection, macroscopic appearence and histologic type of tumor were recorded and patients were divided into groups I-III due to their scores. Patients were also staged according to both tumor node metastases systems. Survival data was analyzed by Kaplan-Meier method. For the comparison of power of the three systems in predicting survival, log-rank and Cox regression analysis were respectively used for univariate and multivariate analysis. 163 resectable gastric cancer patients were evaluated. Median follow-up and survival times were 26 and 23 months respectively. Overall 5-year survival was 37.6%. The number of patients in prognostic scoring groups I, II and III was 44, 109 and 10, respectively. According to tumor node metastases 1992 system, 13, 43, 101 and 6 patients were in stages I, II, III and IV while there were 13, 38, 78 and 34 patients in respective stages in tumor node metastases 1997 system. Although tumor node metastases 1992 (p=0.0088), 1997 (p=0.0029) and prognostic scoring systems (p=0.0006) significantly predicted the survival of patients in univariate analysis, prognostic scoring system was found to be superior compared to other two systems in multivariate analysis (p=0.0002). Prognostic scoring system is a practical, reliable and reproducible method that could be used as an adjunct to tumor node metastases systems in predicting survival of resectable gastric cancer patients.