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Biomedical And Clinical Sciences
Oncology And Carcinogenesis
Predictive And Prognostic Markers
Finding The Minimum Number Of Retrieved Lymph Nodes And Negative Lymph Nodes In Gastric Cancer Surgery: A Real-world Study.

Home
Research Domains
Biomedical And Clinical Sciences
Oncology And Carcinogenesis
Predictive And Prognostic Markers
Finding The Minimum Number Of Retrieved Lymph Nodes And Negative Lymph Nodes In Gastric Cancer Surgery: A Real-world Study.

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Finding the minimum number of retrieved lymph nodes and negative lymph nodes in gastric cancer surgery: a real-world study.

Yingxue Liu^1,2,3, Changming Zhou^4,2, Lu Gan⁵

¹Department of Pathology, Fudan University Shanghai Cancer Center.

International Journal of Surgery (London, England)

|May 16, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Optimizing lymph node retrieval in gastric cancer surgery is crucial. Achieving specific numbers of retrieved lymph nodes (rLNs) and negative lymph nodes (nLNs) improves patient prognosis after gastrectomy.

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Area of Science:

Oncology
Surgical Oncology
Gastroenterology

Background:

Inadequate lymph node retrieval in gastrectomy increases risks of understaging and cancer recurrence.
Establishing standard lymph node retrieval targets is essential for accurate staging and improved patient outcomes.

Purpose of the Study:

To determine the optimal number of retrieved lymph nodes (rLNs) and negative lymph nodes (nLNs) associated with improved survival in gastric adenocarcinoma patients undergoing gastrectomy.
To establish evidence-based guidelines for lymph node retrieval in radical subtotal gastrectomy (RSG) and radical total gastrectomy (RTG).

Main Methods:

Retrospective analysis of gastric adenocarcinoma patients undergoing RSG or RTG (2000-2022).
Restricted cubic spline analysis to identify optimal rLN and nLN thresholds.

Kaplan-Meier survival analysis, log-rank tests, and propensity score matching (PSM) were employed.

Main Results:

For RSG, >=24 rLNs (N0-N3a) and >=32 rLNs (N3b) improved overall survival (OS).
For RTG, >=27 rLNs (N0-N3a) and >=34 rLNs (N3b) improved OS.
>=21 nLNs for RSG and >=22 nLNs for RTG were associated with better OS.

Conclusions:

Recommended rLN thresholds for RSG: 24 (limited metastasis) and 32 (extensive metastasis).
Recommended rLN thresholds for RTG: 27 (limited metastasis) and 34 (extensive metastasis).
Minimum nLN targets: 21 for RSG and 22 for RTG to enhance patient prognosis.