D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer

Detalhes bibliográficos
Autor(a) principal: Sarmento,Bruno José Queiroz
Data de Publicação: 2007
Outros Autores: Brito,Alexandre Menezes, Cardoso,Daniela Medeiros Milhomem, Campoli,Paulo Moacir de Oliveira, Silva,Osterno Queiroz da, Santana-Filho,Jales Benevides, Barreto,Paulo Adriano de Queiroz, Machado,Melissa G., A-Filho,Adalzizio Vieira, Mota,Eliane Duarte, Mota,Orlando Milhomem da
Tipo de documento: Artigo
Idioma: eng
Título da fonte: ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202007000300008
Resumo: BACKGROUND: An important aspect dealing with gastric cancer is the role of lymphadenectomy in gastric cancer staging. AIM: To verify if lymphadenectomy with stations separation increases the number of dissected lymph nodes and establish comparison between TNM 2002 and JGCA 1998 evaluating lymph nodal status (N). METHODS: This is a retrospective analysis of the patients that underwent curative gastrectomy and D2 dissections for adenocarcinoma between 2004 and 2006. Between January of 2004 and June of 2005 (group 1), lymphadenectomy was performed en-bloc with gastrectomy and only TNM system was used. After June of 2005 (group 2), the surgeon himself dissected lymph nodal stations, allowing use of TNM and JGCA systems. Studied aspects were age, Borrmann classification, histological grade, venous or lymphatic invasion, depth of invasion, peritoneal cytology and type of gastrectomy. End points were number of dissected lymph nodes, number of positive lymph nodes and agreement between staging systems. Chi-square test and T-test were used for statistical analysis. RESULTS: One hundred forty-five gastrectomies were performed, 76 in group 1 and 69 in group 2. In group 1, mean age was of 61 years and 59 years in group 2 (P=0,12). Eighty per cent of tumors were advanced in both groups. Venous or lymphatic invasion and positive peritoneal cytology were more frequent in group 1, 65.6% vs 35,3% (P= 0,001) e 13.9% vs 3.1% (P=0,03), respectively. Borrmann classification, histological grade, Lauren classification and type of gastrectomy were not different between the groups. In group 1, mean number of lymph nodes was 32,7 and 37,35 in group 2 (P= 0,09). Rates of positive lymph nodes in groups 1 and 2 were 72.2% and 53%, respectively (P= 0,02). Migration analysis of lymph node status (N) realized only in group 2 (69 patients) showed agreement between TNM and JGCA in 50 patients (72,5%). Using JGCA system, modification in 19 patients occurred (27,5%), with upstaging in 13 (18,8%) and downstaging in six (8,7%). CONCLUSION: In this study, a tendency of increase in number of lymph nodes was verified when the surgeon himself dissected lymph nodal stations. JGCA system modified the lymph nodal staging in comparison to TNM system in 30% of all cases.
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spelling D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancerStomach neoplasmsLymph node excisionDissectionNeoplasm stagingBACKGROUND: An important aspect dealing with gastric cancer is the role of lymphadenectomy in gastric cancer staging. AIM: To verify if lymphadenectomy with stations separation increases the number of dissected lymph nodes and establish comparison between TNM 2002 and JGCA 1998 evaluating lymph nodal status (N). METHODS: This is a retrospective analysis of the patients that underwent curative gastrectomy and D2 dissections for adenocarcinoma between 2004 and 2006. Between January of 2004 and June of 2005 (group 1), lymphadenectomy was performed en-bloc with gastrectomy and only TNM system was used. After June of 2005 (group 2), the surgeon himself dissected lymph nodal stations, allowing use of TNM and JGCA systems. Studied aspects were age, Borrmann classification, histological grade, venous or lymphatic invasion, depth of invasion, peritoneal cytology and type of gastrectomy. End points were number of dissected lymph nodes, number of positive lymph nodes and agreement between staging systems. Chi-square test and T-test were used for statistical analysis. RESULTS: One hundred forty-five gastrectomies were performed, 76 in group 1 and 69 in group 2. In group 1, mean age was of 61 years and 59 years in group 2 (P=0,12). Eighty per cent of tumors were advanced in both groups. Venous or lymphatic invasion and positive peritoneal cytology were more frequent in group 1, 65.6% vs 35,3% (P= 0,001) e 13.9% vs 3.1% (P=0,03), respectively. Borrmann classification, histological grade, Lauren classification and type of gastrectomy were not different between the groups. In group 1, mean number of lymph nodes was 32,7 and 37,35 in group 2 (P= 0,09). Rates of positive lymph nodes in groups 1 and 2 were 72.2% and 53%, respectively (P= 0,02). Migration analysis of lymph node status (N) realized only in group 2 (69 patients) showed agreement between TNM and JGCA in 50 patients (72,5%). Using JGCA system, modification in 19 patients occurred (27,5%), with upstaging in 13 (18,8%) and downstaging in six (8,7%). CONCLUSION: In this study, a tendency of increase in number of lymph nodes was verified when the surgeon himself dissected lymph nodal stations. JGCA system modified the lymph nodal staging in comparison to TNM system in 30% of all cases.Colégio Brasileiro de Cirurgia Digestiva2007-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202007000300008ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.20 n.3 2007reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/S0102-67202007000300008info:eu-repo/semantics/openAccessSarmento,Bruno José QueirozBrito,Alexandre MenezesCardoso,Daniela Medeiros MilhomemCampoli,Paulo Moacir de OliveiraSilva,Osterno Queiroz daSantana-Filho,Jales BenevidesBarreto,Paulo Adriano de QueirozMachado,Melissa G.A-Filho,Adalzizio VieiraMota,Eliane DuarteMota,Orlando Milhomem daeng2012-04-04T00:00:00Zoai:scielo:S0102-67202007000300008Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2012-04-04T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false
dc.title.none.fl_str_mv D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
title D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
spellingShingle D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
Sarmento,Bruno José Queiroz
Stomach neoplasms
Lymph node excision
Dissection
Neoplasm staging
title_short D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
title_full D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
title_fullStr D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
title_full_unstemmed D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
title_sort D2 lymphadenectomy with para-aortic sampling improves lymph node staging for gastric cancer
author Sarmento,Bruno José Queiroz
author_facet Sarmento,Bruno José Queiroz
Brito,Alexandre Menezes
Cardoso,Daniela Medeiros Milhomem
Campoli,Paulo Moacir de Oliveira
Silva,Osterno Queiroz da
Santana-Filho,Jales Benevides
Barreto,Paulo Adriano de Queiroz
Machado,Melissa G.
A-Filho,Adalzizio Vieira
Mota,Eliane Duarte
Mota,Orlando Milhomem da
author_role author
author2 Brito,Alexandre Menezes
Cardoso,Daniela Medeiros Milhomem
Campoli,Paulo Moacir de Oliveira
Silva,Osterno Queiroz da
Santana-Filho,Jales Benevides
Barreto,Paulo Adriano de Queiroz
Machado,Melissa G.
A-Filho,Adalzizio Vieira
Mota,Eliane Duarte
Mota,Orlando Milhomem da
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Sarmento,Bruno José Queiroz
Brito,Alexandre Menezes
Cardoso,Daniela Medeiros Milhomem
Campoli,Paulo Moacir de Oliveira
Silva,Osterno Queiroz da
Santana-Filho,Jales Benevides
Barreto,Paulo Adriano de Queiroz
Machado,Melissa G.
A-Filho,Adalzizio Vieira
Mota,Eliane Duarte
Mota,Orlando Milhomem da
dc.subject.por.fl_str_mv Stomach neoplasms
Lymph node excision
Dissection
Neoplasm staging
topic Stomach neoplasms
Lymph node excision
Dissection
Neoplasm staging
description BACKGROUND: An important aspect dealing with gastric cancer is the role of lymphadenectomy in gastric cancer staging. AIM: To verify if lymphadenectomy with stations separation increases the number of dissected lymph nodes and establish comparison between TNM 2002 and JGCA 1998 evaluating lymph nodal status (N). METHODS: This is a retrospective analysis of the patients that underwent curative gastrectomy and D2 dissections for adenocarcinoma between 2004 and 2006. Between January of 2004 and June of 2005 (group 1), lymphadenectomy was performed en-bloc with gastrectomy and only TNM system was used. After June of 2005 (group 2), the surgeon himself dissected lymph nodal stations, allowing use of TNM and JGCA systems. Studied aspects were age, Borrmann classification, histological grade, venous or lymphatic invasion, depth of invasion, peritoneal cytology and type of gastrectomy. End points were number of dissected lymph nodes, number of positive lymph nodes and agreement between staging systems. Chi-square test and T-test were used for statistical analysis. RESULTS: One hundred forty-five gastrectomies were performed, 76 in group 1 and 69 in group 2. In group 1, mean age was of 61 years and 59 years in group 2 (P=0,12). Eighty per cent of tumors were advanced in both groups. Venous or lymphatic invasion and positive peritoneal cytology were more frequent in group 1, 65.6% vs 35,3% (P= 0,001) e 13.9% vs 3.1% (P=0,03), respectively. Borrmann classification, histological grade, Lauren classification and type of gastrectomy were not different between the groups. In group 1, mean number of lymph nodes was 32,7 and 37,35 in group 2 (P= 0,09). Rates of positive lymph nodes in groups 1 and 2 were 72.2% and 53%, respectively (P= 0,02). Migration analysis of lymph node status (N) realized only in group 2 (69 patients) showed agreement between TNM and JGCA in 50 patients (72,5%). Using JGCA system, modification in 19 patients occurred (27,5%), with upstaging in 13 (18,8%) and downstaging in six (8,7%). CONCLUSION: In this study, a tendency of increase in number of lymph nodes was verified when the surgeon himself dissected lymph nodal stations. JGCA system modified the lymph nodal staging in comparison to TNM system in 30% of all cases.
publishDate 2007
dc.date.none.fl_str_mv 2007-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202007000300008
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dc.language.iso.fl_str_mv eng
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dc.publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
dc.source.none.fl_str_mv ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.20 n.3 2007
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