The effect of preoperative chemotherapy on lymph node yield in gastric cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 80-80
Author(s):  
J. L. Dikken ◽  
P. Krijnen ◽  
C. J. Van De Velde ◽  
M. Verheij ◽  
M. Gonen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Preoperative Chemotherapy ◽  
Distal Gastrectomy ◽  
High Volume ◽  
Curative Surgery ◽  
Lymph Node Yield ◽  
Younger Age ◽  
Node Yield ◽  
The U.S

80 Background: While a minimum of 15 lymphnodes (LNs) should be evaluated for accurate staging of gastric cancer, LN yield in western countries is generally low. With the increasing use of preoperative chemotherapy, it is unknown what the effect of this treatment is on lymph node yield. The aim of the study is therefore to determine whether preoperative chemotherapy influences the number of LNs that can be obtained from specimens of patients who underwent curative surgery for gastric adenocarcinoma. Methods: In1,205 patients from a high-volume U.S. center and 1,220 patients from the Netherlands Cancer Registry (NCR) who underwent a total or distal gastrectomy with curative intent for gastric adenocarcinoma, the LN yield was compared between patients who received preoperative chemotherapy and patients who received no neoadjuvant therapy. Multivariate Poisson regression was used to identify significant predictors of LN retrieval. Results: Of the 2,425 patients who underwent a gastrectomy, 340 patients (14%) received preoperative chemotherapy. Median LN yields were 23 in the U.S. institution and 10 in the NCR. Separate multivariate analyses of the U.S. institution data and the NCR population showed in both groups that preoperative chemotherapy was not associated with a significant difference in LN yield (Table). Factors that were associated with higher LN yield were the same in both groups: female sex, younger age (6% more nodes with every 10 years decrease in age), total gastrectomy (vs. distal gastrectomy) and increasing tumor (T) stage. Conclusions: In both a high-volume cancer center, and a population-based cancer registry, female sex, younger age, total gastrectomy and advanced tumor stage were associated with an increase in lymph node retrieval in surgical specimens. Preoperative chemotherapy did not influence lymph node yield after a resection for gastric cancer. The threshold for what should constitute an adequate assessment of regional lymph nodes after curative surgery for gastric cancer should not be changed after administration of preoperative chemotherapy. [Table: see text] No significant financial relationships to disclose.

Prognostic Value of Lymph Node Yield After Neoadjuvant Chemoradiation for Gastric Cancer

2019 ◽  
Vol 27 (2) ◽  
pp. 534-542 ◽  
Author(s):  
Casey J. Allen ◽  
Timothy J. Vreeland ◽  
Timothy E. Newhook ◽  
Prajnan Das ◽  
Bruce D. Minsky ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Value ◽  
Neoadjuvant Chemoradiation ◽  
Lymph Node Yield ◽  
Node Yield

Identifying Outlier Hospitals in Gastric Cancer Lymph Node Yield Using the National Cancer Database

2021 ◽  
Vol 261 ◽  
pp. 196-204
Author(s):  
Olivia M. Giambra ◽  
Katelyn A. Young ◽  
Christie L. Buonpane ◽  
James T. Dove ◽  
Mohsen M. Shabahang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
National Cancer Database ◽  
Lymph Node Yield ◽  
Node Yield

scholarly journals A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhenghao Cai ◽  
Haiqin Song ◽  
Abe Fingerhut ◽  
Jing Sun ◽  
Junjun Ma ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Microsatellite Instability ◽  
Pathological Examination ◽  
Curative Gastrectomy ◽  
Lymph Node Yield ◽  
Log Odds ◽  
Microsatellite Stability ◽  
The Impact ◽  
Node Yield

Abstract Background The impact of microsatellite status on lymph node (LN) yield during lymphadenectomy and pathological examination has never been assessed in gastric cancer (GC). In this study, we aimed to appraise the association between microsatellite instability-high (MSI-H) and LN yield after curative gastrectomy. Methods We retrospectively analyzed 1757 patients with GC undergoing curative gastrectomy and divided them into two groups: MSI-H (n = 185(10.5%)) and microsatellite stability (MSS) (n = 1572(89.5%)), using a five-Bethesda-marker (NR-24, BAT-25, BAT-26, CAT-25, MONO-27) panel. The median LN count and the percentage of specimens with a minimum of 16 LNs (adequate LN ratio) were compared between the two groups. The log odds (LODDS) of positive LN count (PLNC) to negative LN count (NLNC) and the target LN examined threshold (TLNT(x%)) were calculated in both groups. Results Statistically significant differences were found in the median LN count between MSI-H and MSS groups for the complete cohort (30 vs. 28, p = 0.031), for patients undergoing distal gastrectomy (DG) (30 vs. 27, p = 0.002), for stage II patients undergoing DG (34 vs. 28, p = 0.005), and for LN-negative patients undergoing DG (28 vs. 24, p = 0.002). MSI-H was an independent factor for higher total LN count in patients undergoing DG (p = 0.011), but it was not statistically correlated to the adequate LN ratio. Statistically significant differences in PLNC, NLNC and LODDS were found between MSI-H GC and MSS GC (all p < 0.001). The TLNT(90%) for MSI-H and MSS groups were 31 and 25, respectively. TLNT(X%) of MSI-H GC was always higher than that of MSS GC regardless of the given value of X%. Conclusions MSI-H was associated with higher LN yield in patients undergoing gastrectomy for GC. Although MSI-H did not affect the adequacy of LN harvest, we speculate that a greater lymph node yield is required during pathological examination in MSI-H GC.

Lymph node yield in treatment naïve cases of head and neck squamous cell carcinoma: en bloc lymphadenectomy versus level-by-level dissection

2021 ◽  
pp. 1-8
Author(s):  
K Devaraja ◽  
K Pujary ◽  
B Ramaswamy ◽  
D R Nayak ◽  
N Kumar ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
En Bloc ◽  
Lymph Node Yield ◽  
Node Yield

Abstract Background Lymph node yield is an important prognostic factor in head and neck squamous cell carcinoma. Variability in neck dissection sampling techniques has not been studied as a determinant of lymph node yield. Methods This retrospective study used lymph node yield and average nodes per level to compare level-by-level and en bloc neck dissection sampling methods, in primary head and neck squamous cell carcinoma cases operated between March 2017 and February 2020. Results From 123 patients, 182 neck dissections were analysed, of which 133 were selective and the rest were comprehensive: 55 had level-by-level sampling and 127 had undergone en bloc dissection. The level-by-level method yielded more nodes in all neck dissections combined (20 vs 17; p = 0.097), but the difference was significant only for the subcohort of selective neck dissection (18.5 vs 15; p = 0.011). However, the gain in average nodes per level achieved by level-by-level sampling was significant in both groups (4.2 vs 3.33 and 4.4 vs 3, respectively; both p < 0.001). Conclusion Sampling of cervical lymph nodes level-by-level yields more nodes than the en bloc technique. Further studies could verify whether neck dissection sampling technique has any impact on survival rates.

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