[Advantages of lymph node staging in 872 stomach carcinoma patients]

The German Stomach Cancer TNM Study Group registered 1444 patients from 1982 to 1984 in a multicenter observational study to validate the tumor node metastasis stage groupings. The follow-up-rate in 1989 was 99.4%. Among others the pattern of lymph node metastases and the benefit of systematic lymphadenectomy (SLA) was studied. 872 patients had a resection with or without lymph node staging lymph node metastases were under- or overestimated intraoperatively in 7-23%. More than expected lymph nodes distant from the primary were involved. The survival rate of patients with resected tumors in the distal third of the stomach could be evaluated. We found statistically significant benefit for stage I (UICC 1987) of patients resected with SLA vs. without: 86% respectively 66%. The conclusions are as follows: lymph node involvement is numerous, widespread and also far away from the tumor. The intraoperative statements about lymph node metastases are doubtful. The R0-resection includes the SLA which is improving the survival rate for stage I.