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Revista Colombiana de Cirugía
versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107
Resumo
BORRAEZ-SEGURA, Bernardo A. et al. Postoperative lymph node division and its effect on lymph node count and staging in patients with gastric cancer. rev. colomb. cir. [online]. 2024, vol.39, n.1, pp.94-99. Epub 11-Dez-2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2484.
Introduction.
A gastrectomy and lymph node dissection is the standard of management for patients with gastric cancer. Factors such as the identification of nodes by the pathologist can have a negative impact on staging and treatment. The objective of this study was to compare the lymph node count of a surgical specimen after a complete gastrectomy (group A) and of a specimen with lymph node by groups (group B).
Methods.
Study of a retrospective database of patients undergoing D2 gastrectomy in the Risaralda section of the Liga Contra el Cancer Gastrointestinal surgical service, Pereira, Colombia. The lymph node count was compared in surgical specimens with and without lymph node division by anatomical regions, prior to sending them to pathology.
Results.
Of the 94 patients who underwent surgery, 65 were from group A and 29 patients were from group B. The average number of nodes was 24.4±8.6 and 32.4±14.4, respectively (p=0.004). The percentage of patients with more than 15 and 25 nodes was lower in group A than in group B (27 vs 57, p=0.432 and 19 vs 24, p=0.014). The average number of patients with a nodal ratio less than 0.2 was higher in group B (72.4% vs 55.4%, p=0.119).
Conclusions.
The results of our study showed that a division by lymph node groups prior to the evaluation of the specimen by the pathology service increases the lymph node count and allows the prognosis of patients to be accurately established, having a positive impact on their staging, to avoid overtreatment.
Palavras-chave : stomach neoplasms; gastrectomy; lymph nodes; lymphatic metastasis; lymph node excision; neoplasm staging.