Retrieval of 30 Lymph Nodes Is Mandatory for Selected Stage II Gastric Cancer Patients

Overview

Journal Front Oncol

Specialty Oncology

Date 2021 May 17

PMID 33996537

Citations 6

Authors

Yong-He Chen

Jun Lu

Run-Cong Nie

Dan Liu

Ai-Hong Liu

Zi-Jian Deng

Xi-Jie Chen

Jun Xiang

Ying-Bo Chen

Chang-Ming Huang

Shi Chen

Jun-Sheng Peng

Affiliations

Soon will be listed here.

Abstract

Background: According to the 8th edition AJCC staging manual, a least of 16 lymph nodes retrieval (LNRs) is the minimal requirement for lymph nodes (LNs) dissection of gastric cancer surgery. Previous studies have shown that increasing the number of LNRs (≥30) prolongs survival for selected patients. However, the necessity of retrieving 30 or more LN for stage II gastric cancer patients is still under debate.

Aim: This study aims to explore the impact of retrieving 30 or more lymph nodes on the survival of stage II cancer patients.

Methods: A total of 1,177 patients diagnosed with stage II gastric cancer were enrolled in this study. The clinicopathological parameters and the impact of different LNRs (<30 or ≥30) and positive lymph node ratio (NR) on overall survival (OS) were retrospectively analyzed.

Results: The mean number of LNRs was 34 ± 15. A total of 44% (518/1,177) of patients had an LNRs <30, while 56% (659/1,177) of patients had an LNRs ≥30. The 5-year survival rate was 81% for all patients, 76% for the LNRs <30 group, and 86% for LNRs ≥30 group, respectively (P = 0.003). The survival benefit of retrieving 30 lymph nodes was significant in certain subgroups: age >60 years/male/underwent total gastrectomy/stage IIB. For N+ patients, higher NR was significantly correlated with poor survival.

Conclusion: The survival benefit of retrieving 30 LNs varies in different subgroups. An LNRs of 30 is mandatory for selected stage II gastric cancer patients.

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