A combined approach for individualized lymphadenectomy in gastric cancer patients.

IF 2.3 4区 医学 Q3 ONCOLOGY
Pathology & Oncology Research Pub Date : 2023-06-29 eCollection Date: 2023-01-01 DOI:10.3389/pore.2023.1611270
Zsolt Varga, Adrienn Bíró, Miklós Török, Dezső Tóth
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引用次数: 0

Abstract

Introduction: Gastric cancer ranks as the fifth most common cancer globally. The presence of lymph node metastasis is a significant prognostic factor influencing survival. Postoperative morbidity and nodal staging accuracy are heavily affected by the extent of lymph node dissection. Our study aimed to explore the potential integration of two contemporary methods, sentinel node navigation surgery (SNNS) and the Maruyama Computer Program (MCP), to improve the accuracy of nodal staging. Materials and methods: We conducted a prospective data collection involving patients with gastric adenocarcinoma from 2008 to 2018 at the Department of Surgery, University of Debrecen, Hungary. Data from 100 consecutive patients were collected. The primary and secondary endpoints included evaluating the rate of node-negative patients and the diagnostic accuracy of our combined approach. Results: Sentinel node mapping was successful in 97 out of 100 patients. We found that using the threshold value of the Maruyama Index (MI) ≥ 28, all metastatic stations of sentinel-node-negative patients could be identified. Our method achieved 100% sensitivity and negative predictive value, with a specificity of 60.42% (95% CI = 46.31%-72.98%). Discussion: The combined application of SNNS and MCP has proven to be an effective diagnostic technique in the synergistic approach for identifying metastasis-positive lymph node stations. Despite its limitations, this combination may assist clinicians in customizing lymphadenectomy for gastric cancer patients.

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对胃癌患者进行个体化淋巴结切除术的综合方法。
简介胃癌是全球第五大常见癌症。淋巴结转移是影响生存率的重要预后因素。术后发病率和结节分期的准确性在很大程度上受到淋巴结清扫范围的影响。我们的研究旨在探索前哨节点导航手术(SNNS)和丸山计算机程序(MCP)这两种现代方法的整合潜力,以提高结节分期的准确性。材料与方法:我们对匈牙利德布勒森大学外科系 2008 年至 2018 年期间的胃腺癌患者进行了前瞻性数据收集。收集了 100 名连续患者的数据。主要和次要终点包括评估结节阴性患者的比率和我们的联合方法的诊断准确性。研究结果100 例患者中有 97 例成功绘制了前哨节点图。我们发现,使用丸山指数(MI)≥ 28 的阈值,可以确定前哨节点阴性患者的所有转移站。我们的方法灵敏度和阴性预测值均为 100%,特异性为 60.42%(95% CI = 46.31%-72.98%)。讨论事实证明,SNNS 和 MCP 的联合应用是一种有效的诊断技术,是识别转移阳性淋巴结站的协同方法。尽管有其局限性,但这一组合可帮助临床医生为胃癌患者定制淋巴结切除术。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
134
审稿时长
4-8 weeks
期刊介绍: Pathology & Oncology Research (POR) is an interdisciplinary Journal at the interface of pathology and oncology including the preclinical and translational research, diagnostics and therapy. Furthermore, POR is an international forum for the rapid communication of reviews, original research, critical and topical reports with excellence and novelty. Published quarterly, POR is dedicated to keeping scientists informed of developments on the selected biomedical fields bridging the gap between basic research and clinical medicine. It is a special aim for POR to promote pathological and oncological publishing activity of colleagues in the Central and East European region. The journal will be of interest to pathologists, and a broad range of experimental and clinical oncologists, and related experts. POR is supported by an acknowledged international advisory board and the Arányi Fundation for modern pathology.
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