Influence of the number of lymph nodes examined on staging of gastric cancer

Lee, H. K.; Yang, Han Kwang; Kim, W. H.; Lee, K. U.; Choe, Kuk Jin; Kim, J. P.

doi:10.1046/j.0007-1323.2001.01875.x

Cited by 120 publications

(113 citation statements)

References 20 publications

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“…According to the JGCA data, cumulative 5-year survival of stage IV patients was 15.3%, 2 and Korean data also showed similar results with 18%. 3 Moreover, among all stage IV patients, 4% to 9% of them are said to be too advanced with no chance of curative surgery and their prognosis is absolutely poor showing less than 10% at 3 years after diagnosis. 16 JGCA suggests extended surgery or palliative surgery as clinical practice and reduction surgery as a clinical study for stage IV patients (T4 and N3 patients are classified as stage IV in this suggestion).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Stage IV Gastric Cancer

Baba

Kuwabara

Ishiguro

et al. 2013

International Surgery

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Stage IV Gastric Cancer

Baba

Kuwabara

Ishiguro

et al. 2013

International Surgery

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“…For example, with regard to the mucin phenotype, MUC1 and MUC5AC expression was less frequent in cardia carcinomas than in non-cardia carcinomas [16] . Therefore, lymph node status mainly depends on routine pathological examinations, previously based on the anatomical station of metastatic lymph nodes, and is classified by the number of metastatic regional lymph nodes [17][18][19] . The problem of lymph node classification based on number of metastatic ones is the stage migration, induced by larger lymph nodes dissected.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

Huang¹,

Lin²,

Lu³

et al. 2008

WJG

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category (χ 2 = 30.82, P < 0.001) and MLR (χ 2 = 69.39, P < 0.001) independently influenced the prognosis. A linear correlation between MLR and the 5-year survival was statistically significant based on the multiple linear regression (β = -0.63, P < 0.001). Hypothetically, the 5-year survival would surpass 50% when MLR was lower than 10%. CONCLUSION:The MLR is an independent prognostic factor for patients with advanced gastric cancer from the cardia and fundus. The decrease of MLR due to adequate number of total resected lymph nodes can improve the survival. Huang CM, Lin BJ, Lu HS, Zhang XF, Li P, Xie JW. Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus.

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“…There are several retrospective studies demonstrating that more extensive lymphadenectomies are correlated with longer survival. A study of 4,789 patients at Seoul National University Hospital found that, for patients with stage IIIB disease, those who had Ͼ35 lymph nodes examined had better survival than those who had Ͻ20 nodes examined [43]. The German Gastric Carcinoma Study Group found, in an analysis of 1,654 patients, that those patients who underwent a radical lymphadenectomy (Ͼ25 lymph nodes) had a significantly higher survival rate than patients who had a standard lymph node dissection for stage II or stage IIIA tumors [37,44].…”

Section: Potential Benefits Of More Extensive Lymphadenectomiesmentioning

confidence: 99%

Lymphadenectomy for Gastric Adenocarcinoma: Should West Meet East?

Yoon

Yang

2009

The Oncologist

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After completing this course, the reader will be able to:1. Calculate the lymph node drainage patterns of gastric adenocarcinoma based on the location of the tumor.2. Differentiate and explain the extent of lymphadenectomies performed in different countries.3. Analyze the risks and benefits of performing more extensive lymphadenectomies for gastric adenocarcinoma.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTThe extent of lymphadenectomy that should be performed for gastric adenocarcinoma has been a topic of persistent debate. In countries such as Japan and Korea, where the incidence of gastric adenocarcinoma is high, more extensive (e.g., D2) lymphadenectomies are routinely performed, usually by experienced surgeons with low morbidity and mortality. In western countries such as the U.S., where the incidence of gastric adenocarcinoma is tenfold lower, the performance of more extensive lymphadenectomies is generally limited to specialized centers, and quite possibly the majority of patients are treated at nonreferral centers with less than a D1 lymphadenectomy. There is little disagreement among gastric cancer experts that the minimum lymphadenectomy that should be performed for gastric adenocarcinoma should be at least a D1 lymphadenectomy. Two large, prospective randomized trials performed in the United Kingdom and the Netherlands failed to demonstrate a survival benefit of D2 over D1 lymphadenectomy, but these trials have been criticized for high surgical morbidity and mortality rates in the D2 group. More recent studies have demonstrated that western surgeons can be trained to perform D2 lymphadenectomies on western patients with low morbidity and mortality. Retrospective analyses and one prospective, randomized trial suggest that there may be some benefits to more extensive lymphadenectomies when performed safely, but this assertion requires further validation. This article provides an update on the current literature regarding the extent of lymphadenectomy for gastric adenocarcinoma.

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Influence of the number of lymph nodes examined on staging of gastric cancer

Abstract: The number of lymph nodes examined did not significantly affect node staging of gastric cancer as long as at least 15 nodes were examined. For stage IIIB, more than 15 lymph nodes may be required for optimal staging.

Cited by 120 publications

References 20 publications

Prognostic Factors for Stage IV Gastric Cancer

Prognostic Factors for Stage IV Gastric Cancer

Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

Lymphadenectomy for Gastric Adenocarcinoma: Should West Meet East?

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