Objective: The aim of the study was to analyze in parallel the 6th and the newest 7th AJJCC/UICC (American Joint Committee on Cancer/ International Union Against Cancer) staging system in order to highlight changes brought about the new staging system.
Methods: We analyzed data obtained retrospectively from 134 hospitalized patients diagnosed with gastric carcinomas, who underwent surgery at the Surgery Clinic of the Emergency County Hospital of Tîrgu Mureş, 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 7th AJJCC/UICC staging system. For statistical analysis we used GraphPad InStat software.
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 6th 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, become pN3 in the new system. Some of pN1 cases turned into pN2 in the new system (p=0.004). The 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.