Lymph node pick up by separate stations: Option or necessity?  

作　　者：Paolo Morgagni Oriana Nanni Elisa Carretta Mattia Altini Luca Saragoni Fabio Falcini Domenico Garcea 

机构地区：[1]Department of General Surgery, Morgagni-Pierantoni Hospital [2]Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS [3]Pathology Unit, Morgagni-Pierantoni Hospital

出　　处：《World Journal of Gastrointestinal Surgery》2015年第5期71-77,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM: To evaluate whether lymph node pick up by separate stations could be an indicator of patients submitted to appropriate surgical treatment. METHODS: One thousand two hundred and three consecutive gastric cancer patients submitted to radical resection in 7 general hospitals and for whom no information was available on the extension of lymphatic dissection were included in this retrospective study. RESULTS: Patients were divided into 2 groups: group A, where the stomach specimen was directly formalinfixed and sent to the pathologist, and group B, where lymph nodes were picked up after surgery and fixed for separate stations. Sixty-two point three percent of group A patients showed < 16 retrieved lymph nodes compared to 19.4% of group B(P < 0.0001). Group B(separate stations) patients had significantly higher survival rates than those in group A [46.1 mo(95%CI: 36.5-56.0) vs 27.7 mo(95%CI: 21.3-31.9); P = 0.0001], independently of T or N stage. In multivariate analysis, group A also showed a higher risk of death than group B(HR = 1.24; 95%CI: 1.05-1.46).CONCLUSION: Separate lymphatic station dissection increases the number of retrieved nodes, leads to better tumor staging, and permits verification of the surgical dissection. The number of dissected stations could potentially be used as an index to evaluate the quality of treatment received.AIM To evaluate whether lymph node pick up byseparate stations could be an indicator of patientssubmitted to appropriate surgical treatment.METHODS： One thousand two hundred and threeconsecutive gastric cancer patients submitted to radicalresection in 7 general hospitals and for whom noinformation was available on the extension of lymphaticdissection were included in this retrospective study.RESULTS： Patients were divided into 2 groups： groupA, where the stomach specimen was directly formalinfixedand sent to the pathologist, and group B, wherelymph nodes were picked up after surgery and fixedfor separate stations. Sixty-two point three percent ofgroup A patients showed 〈 16 retrieved lymph nodescompared to 19.4% of group B （P 〈 0.0001）. GroupB （separate stations） patients had significantly highersurvival rates than those in group A [46.1 mo （95%CI：36.5-56.0） vs 27.7 mo （95%CI： 21.3-31.9）; P = 0.0001],independently of T or N stage. In multivariate analysis,group A also showed a higher risk of death than groupB （HR = 1.24; 95%CI： 1.05-1.46）.CONCLUSION： Separate lymphatic station dissectionincreases the number of retrieved nodes, leads to bettertumor staging, and permits verification of the surgicaldissection. The number of dissected stations couldpotentially be used as an index to evaluate the qualityof treatment received.

关 键 词：Gastric cancer LYMPH node Separatestation PICK up LYMPHADENECTOMY 

分 类 号：R735.2[医药卫生—肿瘤] G252.7[医药卫生—临床医学]