BACKGROUND: While it is suggested that more than 15 lymph nodes (LNs) should be evaluated for accurate staging of gastric cancer, LN yield in western countries is generally low. The effect of preoperative chemotherapy on LN yield in gastric cancer is unknown. The aim of the present study is to determine whether preoperative chemotherapy is associated with any difference in the number of LNs obtained from specimens of patients who underwent curative surgery for gastric adenocarcinoma. PATIENTS AND METHODS: In 1205 patients from Memorial Sloan-Kettering Cancer Center (MSKCC) and 1220 patients from the Netherlands Cancer Registry (NCR) who underwent a gastrectomy with curative intent for gastric adenocarcinoma without receiving preoperative radiotherapy, LN yield was analyzed, comparing patients who received preoperative chemotherapy and patients who received no preoperative therapy. RESULTS: Of the 2425 patients who underwent a gastrectomy, 14% received preoperative chemotherapy. Median LN yields were 23 at MSKCC and 10 in the NCR. Despite this twofold difference in LN yield between the two populations, with multivariate Poisson regression, chemotherapy was not associated with LN yield of either population. Variables associated with increased LN yield were institution, female sex, lower age, total (versus distal) gastrectomy and increasing T-stage. CONCLUSIONS: In this patient series, treatment at MSKCC, female sex, lower age, total gastrectomy and increasing primary tumor stage were associated with a higher number of evaluated LNs. Preoperative chemotherapy was not associated with a decrease in LN yield. Evaluating more than 15 LNs after gastrectomy is feasible, with or without preoperative chemotherapy.
BACKGROUND: While it is suggested that more than 15 lymph nodes (LNs) should be evaluated for accurate staging of gastric cancer, LN yield in western countries is generally low. The effect of preoperative chemotherapy on LN yield in gastric cancer is unknown. The aim of the present study is to determine whether preoperative chemotherapy is associated with any difference in the number of LNs obtained from specimens of patients who underwent curative surgery for gastric adenocarcinoma. PATIENTS AND METHODS: In 1205 patients from Memorial Sloan-Kettering Cancer Center (MSKCC) and 1220 patients from the Netherlands Cancer Registry (NCR) who underwent a gastrectomy with curative intent for gastric adenocarcinoma without receiving preoperative radiotherapy, LN yield was analyzed, comparing patients who received preoperative chemotherapy and patients who received no preoperative therapy. RESULTS: Of the 2425 patients who underwent a gastrectomy, 14% received preoperative chemotherapy. Median LN yields were 23 at MSKCC and 10 in the NCR. Despite this twofold difference in LN yield between the two populations, with multivariate Poisson regression, chemotherapy was not associated with LN yield of either population. Variables associated with increased LN yield were institution, female sex, lower age, total (versus distal) gastrectomy and increasing T-stage. CONCLUSIONS: In this patient series, treatment at MSKCC, female sex, lower age, total gastrectomy and increasing primary tumor stage were associated with a higher number of evaluated LNs. Preoperative chemotherapy was not associated with a decrease in LN yield. Evaluating more than 15 LNs after gastrectomy is feasible, with or without preoperative chemotherapy.
Authors: Naruhiko Ikoma; Jeannelyn S Estrella; Wayne L Hofstetter; Jaffer A Ajani; Keith F Fournier; Paul F Mansfield; John M Skibber; Brian D Badgwell Journal: J Gastrointest Surg Date: 2018-07-27 Impact factor: 3.452
Authors: Jennifer Straatman; Nicole van der Wielen; Miguel A Cuesta; Suzanne S Gisbertz; Koen J Hartemink; Alfredo Alonso Poza; Jürgen Weitz; Fransico Mateo Vallejo; Khurshid Ahktar; Ismael Diez Del Val; Josep Roig Garcia; Donald L van der Peet Journal: Trials Date: 2015-03-27 Impact factor: 2.279
Authors: Shiela S Macalindong; Kwang Hee Kim; Byung-Ho Nam; Keun Won Ryu; Norihito Kubo; Ja Yeon Kim; Bang Wool Eom; Hong Man Yoon; Myeong-Cherl Kook; Il Ju Choi; Young Woo Kim Journal: BMC Cancer Date: 2018-01-12 Impact factor: 4.430
Authors: Nicole van der Wielen; Jennifer Straatman; Freek Daams; Riccardo Rosati; Paolo Parise; Jürgen Weitz; Christoph Reissfelder; Ismael Diez Del Val; Carlos Loureiro; Purificación Parada-González; Elena Pintos-Martínez; Francisco Mateo Vallejo; Carlos Medina Achirica; Andrés Sánchez-Pernaute; Adriana Ruano Campos; Luigi Bonavina; Emanuele L G Asti; Alfredo Alonso Poza; Carlos Gilsanz; Magnus Nilsson; Mats Lindblad; Suzanne S Gisbertz; Mark I van Berge Henegouwen; Uberto Fumagalli Romario; Stefano De Pascale; Khurshid Akhtar; H Jaap Bonjer; Miguel A Cuesta; Donald L van der Peet Journal: Gastric Cancer Date: 2020-07-31 Impact factor: 7.370