Dissecting Lymph Node Stations Into Separate Specimens During Gastrectomy For Gastric Cancer Improves The Quality Of Nodal Status Evaluation: a retrospective cohort study

Abstract

Abstract Background In gastric cancer (GC), the pN-stage is an important prognostic factor influencing treatment. In this study, we explored whether dissecting lymph node stations into separate specimens 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 2016-2019 was reviewed. 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 may lead to a more reliable pN-stage assessment.