Necessity of Harvesting At Least 25 Lymph Nodes in Patients With Stage N2–N3 Resectable Gastric Cancer

Abstract

Supplemental Digital Content is available in the text

Does a Higher Cutoff Value of Lymph Node Retrieval Substantially Improve Survival in Patients With Advanced Gastric Cancer?—Time to Embrace a New Digit

“…Chen et al [19] reported that the mean number of lymph nodes retrieved by D1, D11, and D2 lymphadenectomy was 17, 21, and 28, respectively. Using 25 lymph nodes as the cutoff value, survival benefits were observed in patients with N2 and N3 gastric cancer in the LN >25 group compared with those in the LN <25 group.…”

“…The surgical specimens and lymph nodes were examined by pathologists specializing in gastric cancer using the updated edition of the UICC/ AJCC TNM staging system, which was then converted to the seventh edition at the time of our analysis [9]. For the purposes of the present study, the patients were divided into three groups according to the number of lymph nodes retrieved: patients with 15 harvested lymph nodes (LN 15), patients with 16-25 harvested lymph nodes (LN [16][17][18][19][20][21][22][23][24][25], and patients with >25 harvested lymph nodes (LN >25). The lymph node ratio (LNR) was defined as the ratio between metastatic and examined lymph nodes.…”

“…As a result, many investigators have proposed their ideal cutoff values for the number of lymph nodes dissected to accurately stage the disease and achieve local control [17]. Smith et al [16], Schwarz and Smith [18], and Chen et al [19] argued that the goal of LN 16 dissection appeared insufficient in the context of locally advanced gastric cancer and recommended that the minimum goal should be set at 25 (LN >25). The aim of the present study was to assess the impact of LN >25 retrieval on the survival outcome and survival stratification for patients with gastric cancer undergoing curative-intent gastrectomy.…”

PDLIM1 Stabilizes the E-Cadherin/β-Catenin Complex to Prevent Epithelial–Mesenchymal Transition and Metastatic Potential of Colorectal Cancer Cells

“…A one-way ANOVA and Pearson c 2 test were used for the univariate analyses where appropriate. The survival analysis was performed as previously reported (16). The KaplanMeier method was used to calculate the survival rates.…”

Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

“…Studies suggest that removal and examination of more than 16 nodes might improve survival and increases the accuracy of staging by reducing understaging, which leads to stage migration 14,15 .…”