Clinical significance and principles of the specification procedures for lymph node examination after curative surgery for gastric cancer / 中华胃肠外科杂志

ABSTRACT

So far, the category based on the number of metastatic lymph nodes (eg. pN stage) has been demonstrated to be the optimal staging of lymph node metastasis after curative surgery for gastric cancer. Although pN stage has been updating since 1992, it has been still controversial to guarantee the acquisition for the accurate information of lymph node metastasis from gastric cancer. Generally, stage migration of lymph node metastasis means that number of metastatic lymph node is positively correlated with the extent of lymphadenectomy, and with the expansion of lymphadenectomy extent, occurrence of stage migration of lymph node metastasis may decrease gradually or be avoided (Will-Roger phenomena). Stage migration of lymph node metastasis is considered to have a significant impact on the pathologic stage, prognostic evaluation and strategy formulation of adjuvant therapy. Actually, stage migration of lymph node metastasis may be induced by individual difference in patients, disease stage, special biological behaviors of tumor, extent of lymphadenectomy, procedures of lymph node examination and so on, which may undermine the accurate staging of lymph node metastasis from gastric cancer in clinic. The specification procedures for lymph node examination following the radical lymphadenectomy for gastric cancer are not only the necessary method to figure out the comprehensive information of lymph node metastasis from patients but also the essential evidence to embody the high quality of curative gastrectomy for patients, which may provide the optima database for the further precise diagnosis and treatment of gastric cancer.