Prediction of survival in gastric carcinoma related to lymph node grading by the new American Joint Committee on Cancer/Union International Contre le Cancer System or the Japanese system.

Objective: To compare the classification of gastric cancer adopted by the American Joint Committee on Cancer and the Union International contre le Cancer (AJCC/UICC) (number of nodes involved) with the Japanese classification (sites of nodes involved).

Design: Retrospective study.

Setting: Teaching hospital, Turkey.

Subjects: 134 consecutive patients whose gastric cancer was treated by D2 resection.

Interventions: Kaplan-Meier survival analysis and Cox's regression model.

Main outcome measure: Accuracy of prognosis.

Results: There were no significant differences in survival rates when pN1 and pN2 categories of the AJCC/UICC classification were subdivided into the n1 and n2 categories of the Japanese classification. However, when those in the n1 and n2 categories of the Japanese classification were subdivided into the pN1, pN2 and pN3 categories of the AJCC/UICC classification, survival differed significantly (p = 0.00001). When both classifications were combined in a multivariate analysis the pN category of the AJCC/UICC classification was found to be the most significant independent prognostic factor (p = 0.0001).

Conclusion: Classification of lymph node status by number of nodes (AJCC/UICC) rather than anatomical site (Japanese) gives a more accurate prognosis.