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Classification of gastric carcinoma using the Goseki system provides prognostic information additional to TNM staging
Author(s) -
Songun Ilfet,
van de Velde Cornelis J. H.,
Arends Jan W.,
Blok Paul,
Grond A. Joris K.,
Offerhaus G. Johan A.,
Hermans Jo,
van Krieken Joannes H. J. M.
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19990515)85:10<2114::aid-cncr3>3.0.co;2-u
Subject(s) - medicine , tnm staging system , cancer , eosinophilic , gastric carcinoma , stage (stratigraphy) , kappa , cancer staging , pathology , oncology , radiology , staging system , paleontology , linguistics , philosophy , biology
BACKGROUND Due to the high variability of the epidemiology, genetics, morphology, and biologic behavior of gastric carcinoma, many classification systems are in use, e.g., the World Health Organization (WHO) classification; tumor differentiation; the criteria of Ming, Mulligan, and Laurén; and the recently introduced Goseki classification. In the authors' opinion, the TNM staging is the most valuable classification system, with a prognostic value for survival. METHODS To assess the reproducibility and usefulness of these systems in clinical practice, material from 285 gastric carcinoma patients entered in the Dutch Gastric Cancer Trial was analyzed by a panel of 5 experienced gastrointestinal pathologists. The presence of eosinophilic and lymphocytic infiltrates was analyzed in addition to the TNM staging. RESULTS Of the analyzed classification systems, only TNM stage, tumor differentiation, eosinophilic infiltrate, and the Goseki system contained information associated with the survival of patients with gastric carcinoma. The reproducibility was perfect for tumor differentiation (Kappa 1.00), nearly perfect for the WHO and Goseki classifications (Kappa 0.86 and 0.87, respectively), reasonably good for Laurén and lymphocytic infiltrate (Kappa 0.70), and reasonably good for eosinophilic infiltrate (Kappa 0.42). CONCLUSIONS Of all these systems, the Goseki classification was the only system with prognostic value that is additional to TNM staging. Cancer 1999;85:2114–8. © 1999 American Cancer Society.