The New Changes In The 7th Ajcc/Uicc Staging System Of Gastric Carcinomas

Abstract Objective: The aim of this study was to analyze in parallel the 6 th and the newest 7 th AJJCC/UICC (American Joint Committee on Cancer/ International Union Against Cancer) staging system in order to highlight changes brought by the new staging system. Methods: We analyzed data obtained retrospectively from 134 hospitalized patients diagnosed with gastric carcinomas, who underwent surgery at the Surgery Clinics of the County Emergency Clinical Hospital of Tîrgu Mureș, Romania between 2008-2010. The data have been obtained from histopathology reports, and the analyzed parameters were the following: age, gender and pTNM staging. For all cases included in the study restaging was performed according to the 7 th AJJCC/UICC staging system. Results: 71.66% of cases were adenocarcinomas, 7.46% mucinous adenocarcinoma, 14.17% signet ring cell carcinoma, and 6.71% undifferentiated carcinoma. The signet ring cell carcinomas predominated before 65 years of age (p = 0.003). Compared to the 6 th staging system, in the new system pT2 percentages decreased significantly from 38.8% to 6.71%, and pT4 increases from 11.19% to 55.97% (p <0.0001). The pN3 cases increased from 20.9% to 45.52%, because all cases classified as pN2 in the old staging system, became pN3 in the new system. Some of the pN1 cases turned into pN2 in the new system (p = 0.004). Stage IV cases also decreased from 29.85% to 14.94%, due to regrouping of stage III. Conclusions: There are significant changes between the two staging systems. The new staging system aims to achieve a better postoperative follow-up.