Evaluation of a new staging system by the Japanese Research Society for Gastric Cancer

(Received for publication on Sept. 29, 1997; accepted on Jan. 6, 1998)     

Evaluation of pT2 subdivisions in the TNM staging system for prostate cancer

OBJECTIVE

To evaluate the subclassifications of pT2 diseases in tumour‐nodes‐metastases (TNM) staging system for prostate cancer.

PATIENTS AND METHODS

We retrospectively analysed the data of 372 patients who underwent radical retropubic prostatectomy (RRP) for pathologically organ‐confined prostate cancer at our institution. Pathological staging of all subjects were re‐evaluated using the 1997 and the 2002 TNM staging system for prostate cancer. Various clinicopathological features along with biochemical recurrence‐free survival (BRFS) of pT2 subgroups were assessed.

RESULTS

Using the 2002 TNM staging criteria, 87 of the tumours (23.4%) were pT2a, and 284 (76.3%) were pT2c. Of all subjects, there was only one (0.3%) pathological 2002 T2b tumour identified. When subjects were classified according to the 1997 versions of the T2 subclassification (pT2a vs pT2b), the 1997 pT2a and pT2b cases showed no significant difference regarding BRFS (log‐rank P = 0.645) among those who were followed‐up for >2 years after RRP. Also, pathological stage (1997 pT2a vs pT2b) was not a significant predictor of BRFS in either uni‐ or multivariate analysis (P = 0.289 and P = 0.241, respectively). Only preoperative serum PSA level and pathological Gleason score along with positive surgical margin were significant predictors of PSA outcome after RRP on multivariate analysis.

CONCLUSION

Our results suggest that two‐ or three‐tiered subclassification of pT2 organ‐confined prostate cancer via methods used in the previous or current TNM staging system may not be appropriate. Efforts should be made to upgrade the current TNM staging system for prostate cancer.     

国际肺癌研究协会(IASLC)第八版肺癌TNM分期解读

准确的TNM分期是肺癌诊断、治疗以及判断预后的重要因素。目前临床上所使用的非小细胞肺癌分期是国际抗癌联盟(UICC)于2009年颁布的第七版分期。随着肺癌治疗模式的发展、新的诊断技术以及治疗手段的涌现,肺癌的疗效及其预后也有了明显改善,旧的分期标准亟待更新。2015年9月国际肺癌研究协会(IASLC)公布了新修订的肺癌TNM分期系统,并计划于2017年1月正式颁布实施。新分期标准采纳了来自16个国家的35个数据库,包含了自1999年至2010年间新发病的94 708例肺癌病例。该文就IASLC近期发布的第八版肺癌TNM分期进行初步解读。     

第8版国际抗癌联盟和美国癌症联合委员会胃癌TNM分期系统简介及解读

目前胃癌的TNM分期已经成为临床胃癌诊疗的首选参考依据。在国际抗癌联盟(UICC)、国际胃癌协会(IGCA)和美国癌症联合委员会(AJCC)的共同协作推动下,通过对全世界范围内胃癌大数据的收集与分析,于2016年10月颁布了第8版胃癌TNM分期系统。第8版TNM分期系统对食管-胃结合部及贲门癌分期标准的选择做出了明确的定义;同时还在单一分期系统的基础上新增了临床TNM分期(cTNM)和新辅助治疗后分期(ypTNM)。此外,新版的分期系统将N3的两个亚组N3a和N3b作为独立组别纳入到分期系统,还对组织学分级进行了一些调整。总的来说,相比第7版胃癌TNM分期系统,新版的分期系统可以指导临床医生更加合理地制定治疗方案,更加科学地评价治疗效果,更加准确地评估预后。然而,随着临床广泛应用和进一步验证,以及新的预测因子的发现,必将会有新的分期系统替代和完善旧的分期系统。     

Complications and the learning curve for a laparoscopic nephrectomy at a single institution

BACKGROUND: We assessed our experiences in performing a laparoscopic nephrectomy, with regard to complications and the learning curve, during a 4-year period. METHODS: Between November 2000 and October 2004, a total of 78 laparoscopic nephrectomies were performed at our institution (37 radical nephrectomies, 30 nephroureterectomies and 11 simple nephrectomies). The patient charts were retrospectively reviewed to identify any operative and postoperative complications, and also to evaluate the operating time. RESULTS: A total of eleven complications (14.1%) occurred in our series (nine operative and two postoperative complications). All operative complications were due to vascular injuries (n=9), five (2.6%) of which required an open conversion. The operating time and the rates of complications decreased significantly as the surgeons' experiences increased. CONCLUSION: A laparoscopic nephrectomy could be performed as safely as previously reported. In addition, the learning curve for a laparoscopic nephrectomy appeared to be good over the initial 50 procedures at our institution.