How Should We Measure the Quality of Lymphadenectomy for Gastric Cancer? Anatomical Versus Numerical Criterion

J Gastrointest Cancer. 2020 Sep;51(3):887-892. doi: 10.1007/s12029-019-00321-x.

Abstract

Aim: To compare anatomical with numerical criterion to measure the quality of lymphadenectomy for gastric cancer.

Patients and methods: We analyzed 447 gastric cancer patients with resectable tumor stage (R0 resection) with at least 16 examined lymph nodes.

Results: Of 447 patients, 82.6% underwent D2 lymphadenectomy for a median of total examined lymph nodes of 28. The 7-year disease-specific survival rate for the whole sample was 71.4%. Survival was significantly different between patients treated with D2 and D1 lymphadenectomy (77.4% versus 44.3%; p < 0.001) and between patients with total examined lymph nodes ≥ 28 and < 28 (74.5% versus 62.3%; p = 0.041). Anatomical criterion significantly differentiated 7-year survival in patients stratified according to a numerical parameter.

Conclusion: We should still consider the anatomical criterion as the best item to measure the quality of lymphadenectomy for gastric cancer.

Keywords: Cancer-related survival; Locally advanced gastric cancer; Lymphadenectomy; Number of removed lymph nodes.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Gastrectomy / methods*
  • Humans
  • Lymph Node Excision / methods*
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Male
  • Middle Aged
  • Prognosis
  • Quality Assurance, Health Care / statistics & numerical data*
  • Retrospective Studies
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • Survival Rate