By Elda Hauschildt
Tumour staging is not reliable in gastric carcinoma when fewer than 10 lymph nodes are examined. French researchers suggest the number of examined lymph nodes should be used as a criterion of stratification in clinical trials and as an adjustment variable in studies of survival. Investigators from the Registre bourguignon des cancer digestifs, Cabinet chirurgical, Centre Hospitalier Universitaire and the Centre de Pathologie in Dijon studied 741 patients with TNM Stage I, II or III resected gastric carcinoma.
Participants represented all patients diagnosed in a 21-year period in a well-defined French population.
Researchers modeled the relationship between the proportion of positive nodes and the number of nodes examined to determine the number of nodes beyond which the proportion of N+ tumours no longer changed.
They found the average number of examined lymph nodes per patient was 8.4. Only 17.6 percent of patients had more than 15 lymph nodes examined. Investigators report that the proportion of N+ classified tumours decreased significantly when the number of examined nodes was less than 10. It remained stable beyond this value.
They found two factors were independently associated with the resection of at least 10 nodes: type of gastrectomy and patient age.
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