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Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation

BACKGROUND: In gastric cancer (GC), the pN-stage is an important prognostic factor influencing treatment. Along with the depth of invasion of the tumor, the presence of nodal metastases is one of the most important prognostic factors guiding treatment strategies in gastric cancer. Examining a small...

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Autores principales: Fernström, Aleksi, Kokkola, Arto, Korpela, Akseli, Puolakkainen, Pauli, Louhimo, Johanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463918/
https://www.ncbi.nlm.nih.gov/pubmed/37626384
http://dx.doi.org/10.1186/s12957-023-03146-y
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author Fernström, Aleksi
Kokkola, Arto
Korpela, Akseli
Puolakkainen, Pauli
Louhimo, Johanna
author_facet Fernström, Aleksi
Kokkola, Arto
Korpela, Akseli
Puolakkainen, Pauli
Louhimo, Johanna
author_sort Fernström, Aleksi
collection PubMed
description BACKGROUND: In gastric cancer (GC), the pN-stage is an important prognostic factor influencing treatment. Along with the depth of invasion of the tumor, the presence of nodal metastases is one of the most important prognostic factors guiding treatment strategies in gastric cancer. Examining a small number of lymph nodes may lead to understaging of the disease; hence, it is essential for the nodal status to be precisely assessed. In this study, we explored whether dissecting lymph node stations into separate samples by the surgeon from the gastric cancer surgical specimen affects the quality of nodal status evaluation and patient outcome. METHODS: The clinical data of 130 GC patients treated at the Helsinki University Hospital between 2016 and 2019 was reviewed. The performed operations included 59 total and 71 subtotal gastrectomies. The processing of the surgical specimen before the pathological examination was assessed from the operation records and pathology reports. The association of the number of examined lymph nodes with other variables was assessed, and multivariate survival analysis was performed to explore the independent prognostic factors in disease-specific survival. RESULTS: Dissecting lymph node stations into separate specimens before pathological evaluation yielded a significantly greater number of examined lymph nodes compared with a specimen without intervention (median 34.5 vs 21.0, p < 0.001). The pT-stage, the pN-stage, and the extent of lymphadenectomy were identified as independent prognostic factors, whereas dissecting the specimen’s lymph node stations did not associate with survival. CONCLUSIONS: Dissecting lymph node stations into separate specimens results in a greater number of examined lymph nodes, which has the potential to lead to a more reliable pN-stage assessment.
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spelling pubmed-104639182023-08-30 Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation Fernström, Aleksi Kokkola, Arto Korpela, Akseli Puolakkainen, Pauli Louhimo, Johanna World J Surg Oncol Research BACKGROUND: In gastric cancer (GC), the pN-stage is an important prognostic factor influencing treatment. Along with the depth of invasion of the tumor, the presence of nodal metastases is one of the most important prognostic factors guiding treatment strategies in gastric cancer. Examining a small number of lymph nodes may lead to understaging of the disease; hence, it is essential for the nodal status to be precisely assessed. In this study, we explored whether dissecting lymph node stations into separate samples by the surgeon from the gastric cancer surgical specimen affects the quality of nodal status evaluation and patient outcome. METHODS: The clinical data of 130 GC patients treated at the Helsinki University Hospital between 2016 and 2019 was reviewed. The performed operations included 59 total and 71 subtotal gastrectomies. The processing of the surgical specimen before the pathological examination was assessed from the operation records and pathology reports. The association of the number of examined lymph nodes with other variables was assessed, and multivariate survival analysis was performed to explore the independent prognostic factors in disease-specific survival. RESULTS: Dissecting lymph node stations into separate specimens before pathological evaluation yielded a significantly greater number of examined lymph nodes compared with a specimen without intervention (median 34.5 vs 21.0, p < 0.001). The pT-stage, the pN-stage, and the extent of lymphadenectomy were identified as independent prognostic factors, whereas dissecting the specimen’s lymph node stations did not associate with survival. CONCLUSIONS: Dissecting lymph node stations into separate specimens results in a greater number of examined lymph nodes, which has the potential to lead to a more reliable pN-stage assessment. BioMed Central 2023-08-26 /pmc/articles/PMC10463918/ /pubmed/37626384 http://dx.doi.org/10.1186/s12957-023-03146-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Fernström, Aleksi
Kokkola, Arto
Korpela, Akseli
Puolakkainen, Pauli
Louhimo, Johanna
Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title_full Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title_fullStr Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title_full_unstemmed Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title_short Separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
title_sort separating lymph node stations by the surgeon from the gastric cancer specimen improves the quality of nodal status evaluation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463918/
https://www.ncbi.nlm.nih.gov/pubmed/37626384
http://dx.doi.org/10.1186/s12957-023-03146-y
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