Importance of Examined Lymph Node Number in Accurate Staging and Enhanced Survival in Resected Gastric Adenocarcinoma - The More, the Better? A Cohort Study of 8696 Cases from the US and China, 2010-2016

2019 ◽  
Author(s):  
Lei Huang ◽  
Zhi-Jian Wei ◽  
A-Man Xu
Keyword(s):  
Cohort Study ◽  
Lymph Node ◽  
Gastric Adenocarcinoma ◽  
Node Number ◽  
Accurate Staging ◽  
The Us ◽  
Lymph Node Number

scholarly journals Importance of Examined Lymph Node Number in Accurate Staging and Enhanced Survival in Resected Gastric Adenocarcinoma—The More, the Better? A Cohort Study of 8,696 Cases From the US and China, 2010–2016

2021 ◽  
Vol 10 ◽  
Author(s):  
Lei Huang ◽  
Xinyue Zhang ◽  
Zhijian Wei ◽  
Aman Xu
Keyword(s):  
Cohort Study ◽  
Lymph Node ◽  
Gastric Adenocarcinoma ◽  
Proportional Hazards ◽  
Patient Survival ◽  
Stage Migration ◽  
Cox Models ◽  
Node Number ◽  
Accurate Staging ◽  
The Us

BackgroundWhile most guidelines advocate D2 lymphadenectomy for non-metastatic gastric adenocarcinoma (nmGaC), it is not always performed as standard of care outside East Asia. The recommended minimal examined lymph node (ELN) count in nmGaC to stage cancer accurately varies largely across guidelines, and the optimal count to satisfactorily stratify patient survival has yet to be determined. This large cohort study aimed at robustly defining the minimal and optimal thresholds of examined lymph node (ELN) number in non-metastatic gastric adenocarcinoma (nmGaC).MethodsData on nmGaC patients operated in 2010–2016 and surviving ≥3 months were retrieved from the US SEER-18 Program and a Chinese multi-institutional gastric cancer database (MIGC). The correlation of ELN count with stage migration and patient survival were quantified with the use of the multivariable-adjusted logistic and proportional hazards Cox models, respectively. The sequences of odds ratios (ORs) and hazard ratios (HRs) for each additional ELN were smoothed, and the structural breakpoints were determined.ResultsTogether 7,228 patients from the US and 1,468 from China were analyzed, encompassing 23,114 person-years of follow-up. The mean ELN count was 20 in the US and 30 in China. With more ELNs, both cohorts significantly showed proportional increases from lower to higher nodal stage (ORSEER = 1.03, 95%-CI = 1.03–1.04; ORMIGC = 1.02, 95%-CI = 1.02–1.03) and sequential enhancements in postoperative survival (HRSEER = 0.97, 95%-CI = 0.97–0.97; HRMIGC = 0.98, 95%-CI = 0.97–0.99). Correlations for both stage migration and survival were still significant in most subgroups by patient, cancer, and management factors. Breakpoint analyses revealed a minimum threshold ELN count of 17 and an optimum count of 33, which were validated in both cohorts with good efficacy to differentiate probabilities of both stage migration and survival.ConclusionIn resected nmGaC patients with anticipated survival ≥3 months, more ELNs are correlated with more accurate staging, which may partly explain the survival correlation. This observational investigation does not indicate causality. Our findings robustly conclude 17 ELNs as the minimum and propose 33 ELNs as the optimum thresholds, to assess the quality of lymph node examination and to stratify postsurgical survival.

scholarly journals Analytic lymph node number establishes staging accuracy by occult tumor burden in colorectal cancer

2012 ◽  
Vol 106 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Terry Hyslop ◽  
David S. Weinberg ◽  
Stephanie Schulz ◽  
Alan Barkun ◽  
Scott A. Waldman
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Tumor Burden ◽  
Node Number ◽  
Occult Tumor ◽  
Staging Accuracy ◽  
Lymph Node Number

Metastatic lymph node number in epithelial ovarian carcinoma: Does it have any clinical significance?

2008 ◽  
Vol 108 (2) ◽  
pp. 428-432 ◽  
Author(s):  
Ali Ayhan ◽  
Murat Gultekin ◽  
Polat Dursun ◽  
Nasuh Utku Dogan ◽  
Guldeniz Aksan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Ovarian Carcinoma ◽  
Clinical Significance ◽  
Metastatic Lymph Node ◽  
Epithelial Ovarian Carcinoma ◽  
Node Number ◽  
Metastatic Lymph ◽  
Lymph Node Number

Prognostic role of metastatic lymph node number and lymph node ratio in ampullary adenocarcinoma

2018 ◽  
Vol 4 (1) ◽  
pp. 1-12
Author(s):  
Fiammetta Soggiu ◽  
◽  
Mikael Sodergren ◽  
Eleftheria Kalaitzaki ◽  
Jeremy Thompson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Ratio ◽  
Metastatic Lymph Node ◽  
Prognostic Role ◽  
Ampullary Adenocarcinoma ◽  
Node Number ◽  
Metastatic Lymph ◽  
Node Ratio ◽  
Lymph Node Number
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