AIM: To evaluate whether lymph node pick up by separate stations could be an indicator of patients submitted to appropriate surgical treatment. METHODS: One thousand two hundred and three consecutive gastric cancer patients submitted to radical resection in 7 general hospitals and for whom no information was available on the extension of lymphatic dissection were included in this retrospective study. RESULTS: Patients were divided into 2 groups: group A, where the stomach specimen was directly formalin-fixed and sent to the pathologist, and group B, where lymph nodes were picked up after surgery and fixed for separate stations. Sixty-two point three percent of group A patients showed < 16 retrieved lymph nodes compared to 19.4% of group B (P < 0.0001). Group B (separate stations) patients had significantly higher survival rates than those in group A [46.1 mo (95%CI: 36.5-56.0) vs 27.7 mo (95%CI: 21.3-31.9); P = 0.0001], independently of T or N stage. In multivariate analysis, group A also showed a higher risk of death than group B (HR = 1.24; 95%CI: 1.05-1.46). CONCLUSION: Separate lymphatic station dissection increases the number of retrieved nodes, leads to better tumor staging, and permits verification of the surgical dissection. The number of dissected stations could potentially be used as an index to evaluate the quality of treatment received.
AIM: To evaluate whether lymph node pick up by separate stations could be an indicator of patients submitted to appropriate surgical treatment. METHODS: One thousand two hundred and three consecutive gastric cancerpatients submitted to radical resection in 7 general hospitals and for whom no information was available on the extension of lymphatic dissection were included in this retrospective study. RESULTS:Patients were divided into 2 groups: group A, where the stomach specimen was directly formalin-fixed and sent to the pathologist, and group B, where lymph nodes were picked up after surgery and fixed for separate stations. Sixty-two point three percent of group A patients showed < 16 retrieved lymph nodes compared to 19.4% of group B (P < 0.0001). Group B (separate stations) patients had significantly higher survival rates than those in group A [46.1 mo (95%CI: 36.5-56.0) vs 27.7 mo (95%CI: 21.3-31.9); P = 0.0001], independently of T or N stage. In multivariate analysis, group A also showed a higher risk of death than group B (HR = 1.24; 95%CI: 1.05-1.46). CONCLUSION: Separate lymphatic station dissection increases the number of retrieved nodes, leads to better tumor staging, and permits verification of the surgical dissection. The number of dissected stations could potentially be used as an index to evaluate the quality of treatment received.
Entities:
Keywords:
Gastric cancer; Lymph node; Lymphadenectomy; Separate station pick up
Authors: Franco Roviello; Daniele Marrelli; Paolo Morgagni; Giovanni de Manzoni; Alberto Di Leo; Carla Vindigni; Luca Saragoni; Anna Tomezzoli; Hayato Kurihara Journal: Ann Surg Oncol Date: 2002-11 Impact factor: 5.344
Authors: M Degiuli; M Sasako; M Calgaro; M Garino; F Rebecchi; M Mineccia; D Scaglione; D Andreone; A Ponti; F Calvo Journal: Eur J Surg Oncol Date: 2004-04 Impact factor: 4.424
Authors: Alberto Marchet; Simone Mocellin; Alessandro Ambrosi; Paolo Morgagni; Domenico Garcea; Daniele Marrelli; Franco Roviello; Giovanni de Manzoni; Annamaria Minicozzi; Giovanni Natalini; Francesco De Santis; Luca Baiocchi; Arianna Coniglio; Donato Nitti Journal: Ann Surg Date: 2007-04 Impact factor: 12.969
Authors: G de Manzoni; G Verlato; F Roviello; P Morgagni; A Di Leo; L Saragoni; D Marrelli; H Kurihara; F Pasini Journal: Br J Cancer Date: 2002-07-15 Impact factor: 7.640