Lymphadenectomy with Optimum of 29 Lymph Nodes Retrieved Associated with Improved Survival in Advanced Gastric Cancer: A 25,000-Patient International Database Study.
Yanghee Woo,Bryan Goldner,Philip H.G. Ituarte,Byrne Lee,Laleh G. Melstrom,Taeil Son,Sung Hoon Noh,Yuman Fong,Woo Jin Hyung +8 more
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TLDR
This large international dataset analysis demonstrates that the maximal survival advantage is seen by performing a lymphadenectomy with a minimum of 29 LNs retrieved.Abstract:
Background Gastric adenocarcinoma is an aggressive disease with frequent lymph node (LN) metastases for which lymphadenectomy results in a survival benefit. In the US, the National Comprehensive Cancer Network guidelines recommend D2 lymphadenectomy or a minimum of 15 LNs retrieved. However, retrieval of only 15 LNs is considered by most international guidelines as inadequate. We sought to evaluate the survival benefits associated with a more complete lymphadenectomy. Study Design An international database was constructed by combining gastric cancer cases from the Surveillance, Epidemiology, and End Results program database (n = 13,932) and the Yonsei University Gastric Cancer database (n = 11,358) (total n = 25,289). Kaplan-Meier survival analysis was performed along with Joinpoint analysis to obtain the optimal number of LNs to retrieve based on survival. Prognostic significance of number of nodes retrieved was then confirmed with univariate and multivariate analyses. Results Analysis for both mean and median survival yielded 29 LNs removed as the Joinpoint. This was confirmed with multivariate analysis, where 15 retrieved LNs cutoff fell out of the model and 29 retrieved LNs remained intact, with a hazard ratio of 0.799 (95% CI 0.759 to 0.842; p Conclusions Joinpoint analysis has allowed for the creation of a model demonstrating the point at which additional dissection would not provide additional benefit. This large international dataset analysis demonstrates that the maximal survival advantage is seen by performing a lymphadenectomy with a minimum of 29 LNs retrieved.read more
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Safety and Efficacy of Indocyanine Green Tracer-Guided Lymph Node Dissection During Laparoscopic Radical Gastrectomy in Patients With Gastric Cancer: A Randomized Clinical Trial.
Qi-Yue Chen,Jian-Wei Xie,Qing Zhong,Jia-Bin Wang,Jian-Xian Lin,Jun Lu,Long-Long Cao,Mi Lin,Ru-Hong Tu,Ze-Ning Huang,Ju-Li Lin,Hua-Long Zheng,Ping Li,Chao-Hui Zheng,Chang-Ming Huang +14 more
TL;DR: Indocyanine green can noticeably improve the number of lymph node dissections and reduce lymph node noncompliance without increased complications in patients undergoing D2 lymphadenectomy.
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Deep neural network-assisted computed tomography diagnosis of metastatic lymph nodes from gastric cancer.
Yuan Gao,Zhengdong Zhang,Shuo Li,Yu-Ting Guo,Qingyao Wu,Shuhao Liu,Shujian Yang,Lei Ding,Bao-Chun Zhao,Shuai Li,Yun Lu +10 more
TL;DR: Through deep learning, FR-CNN achieved high judgment effectiveness and recognition accuracy for CT diagnosis of perigastric metastatic lymph nodes (PGMLNs) and to acquire more accurate identification results.
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Multi-institutional validation of the 8th AJCC TNM staging system for gastric cancer: Analysis of survival data from high-volume Eastern centers and the SEER database.
Taeil Son,Jiyu Sun,Seo Hee Choi,Minah Cho,In Gyu Kwon,Hyoung Il Kim,Jae Ho Cheong,Seung Ho Choi,Sung Hoon Noh,Yanghee Woo,Yuman Fong,Sohee Park,Woo Jin Hyung +12 more
TL;DR: The clinical relevance and general applicability of the 8th American Joint Committee on Cancer TNM gastric cancer staging system vs the 7th version have not been examined using datasets from both the East and West.
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Laparoscopic versus open distal gastrectomy for advanced gastric cancer: A meta-analysis of randomized controlled trials and high-quality nonrandomized comparative studies
TL;DR: LDG with D2 lymphadenectomy is a safe and effective technique for patients with AGC when performed by experienced surgeons at high-volume specialized centers.
Journal ArticleDOI
Number of retrieved lymph nodes is an independent prognostic factor after total gastrectomy for patients with stage III gastric cancer: propensity score matching analysis of a multi-institution dataset.
Shogo Hayashi,Mitsuro Kanda,Seiji Ito,Yoshinari Mochizuki,Hitoshi Teramoto,Kiyoshi Ishigure,Toshifumi Murai,Takahiro Asada,Akiharu Ishiyama,Hidenobu Matsushita,Chie Tanaka,Daisuke Kobayashi,Michitaka Fujiwara,Kenta Murotani,Yasuhiro Kodera +14 more
TL;DR: RLN < 40 was associated with an adverse prognosis of patients with stage III gastric cancer who underwent total gastrectomy and was an independent prognostic factor in multivariable analysis, although pathological N status was not.
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