UICC and Japanese stage classifications for carcinoma of the pancreas

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Abstract
Summary The stage classification (SC) for carcinoma of the pancreas recommended by UICC (UICC-SC) was compared with that of Japan Pancreas Society (JPN-SC) using 229 patients encountered consecutively at the Second Department of Surgery, Nagasaki University School of Medicine over the past 20 yr. By UICC-SC, 51% of the patients belonged to stage IV and 38% to Stage III. By JPN-SC, 82% of the patients belonged to stage IV. Curative resection rates in JPN stage II and III were significantly higher than those in UICC-SC by the chi-squared test. In 60 patients undergoing resectional surgery, postoperative cumulative survival (PCS) curves and rates by each staging criterion (tumor size [T], lymph node metastasis [N], distant metastasis [M], serosal invasion [S], retroperitoneal invasion [Rp], and invasion to the portal venous systems [V]) were calculated by the Kaplan-Meier method. Among these prognostic factors, significant differences in the PCS curves were demonstrated only between Rp(-) and Rp(+), and between V( - ) and V( + ) according to the generalized Wilcoxon’s text. In UICC-SC, the underestimation of these factors leads to a tendency to classify the patients in a less advanced stage than in JPN-SC. JPN-SC is more complex than UICC-SC. Continuing efforts are necessary to establish a more practical, simple, and universal staging system for the disease.