Gastric cancer: Extent of lymph node dissection and requirements for a correct staging

Luca Cozzaglio, Roberto Doci, Simone Celotti, Massimo Roncalli, Leandro Gennari

Research output: Contribution to journalArticlepeer-review

Abstract

Aims and background: Lymphatic spread is an important prognostic factor in gastric cancer. The TNM classification requires at least 15 lymph nodes to stage and identify three prognostic groups according to the number of metastatic lymph nodes: N1 (1-6), N2 (7-15), N3 (>15). The aim of this study was to investigate which type of lymph node dissection allows an accurate staging. Methods: From 1996 to 2001, we treated 140 gastric cancer patients, 27 with D1 and 113 with D2 dissection. We evaluated lymph node count, status and ratio between metastatic and total number of excised lymph nodes, keeping 20% as the cutoff value. Results: The mean number of lymph nodes was 18 and 33 respectively for D1 and D2 (P 1 and 5% in D2 had less than 15 lymph nodes (P 1 and 73% in D2 (P = 0.145) had lymph node metastases, but this incidence decreased to 36% (P = 0.045) and 16% (P 1 and D2 when less than 15 lymph nodes were available. Considering the ratio between metastatic and total number of lymph nodes, 45% of D1 versus 3% of D2 (P 2 lymph node dissection is better than D1 in providing at least 15 lymph nodes required for a correct staging. We confirm the risk of a downstage when less than 15 lymph nodes are available.

Original languageEnglish
Pages (from-to)467-472
Number of pages6
JournalTumori
Volume90
Issue number5
Publication statusPublished - Sep 2004

Keywords

  • Gastric cancer
  • Lymph node metastases
  • Lymphadenectomy
  • Staging

ASJC Scopus subject areas

  • Cancer Research

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