Weikeat K Ooi, Sander J M van Hootegem, Low Kuan Yean, Leonie R van der Werf, Pieter Christiaan van der Sluis, S M Lagarde, Bas P L Wijnhoven
{"title":"胃癌手术中淋巴结数量与生存率的关系:一项基于荷兰人群的研究。","authors":"Weikeat K Ooi, Sander J M van Hootegem, Low Kuan Yean, Leonie R van der Werf, Pieter Christiaan van der Sluis, S M Lagarde, Bas P L Wijnhoven","doi":"10.1159/000546436","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate whether the retrieval of 15 or more lymph nodes (LN) during gastrectomy for cancer is associated with better survival and more accurate pathological staging.</p><p><strong>Methods: </strong>Patients that underwent gastrectomy between 2011 and 2016 were reviewed from the Dutch Upper Gastrointestinal Cancer Audit. Patients with <15 and ≥15 LN retrieved were compared after propensity-score matching based on patient and tumor characteristics. The primary endpoint was 3-year overall survival.</p><p><strong>Results: </strong>A total of 2047 patients were included in the study. After propensity score matching, 522 patients with ≥15 LNs were matched to 522 patients with <15 LNs. There was no statistically significant difference in overall survival between both groups, with 3-year survival rates of 56% versus 59%, respectively. Patients with ≥15 LNs had a more advanced pN-category. While median survival was higher for patients with ≥15 LNs versus <15 LNs in the subgroups pN2, pN3a, and pN3b, no statistically significant differences were found. Similar results were found in the propensity score matched cohort using 23 LNs as cut-off.</p><p><strong>Conclusions: </strong>≥15 LNs retrieved during gastrectomy for cancer was associated with higher pN-stage, likely as a result of stage migration. Three-year overall survival was comparable for patients with ≥15 LNs and patients with <15 LNs retrieved.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-20"},"PeriodicalIF":1.8000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The association between number of retrieved lymph nodes and survival in gastric cancer surgery: a Dutch population-based study.\",\"authors\":\"Weikeat K Ooi, Sander J M van Hootegem, Low Kuan Yean, Leonie R van der Werf, Pieter Christiaan van der Sluis, S M Lagarde, Bas P L Wijnhoven\",\"doi\":\"10.1159/000546436\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to evaluate whether the retrieval of 15 or more lymph nodes (LN) during gastrectomy for cancer is associated with better survival and more accurate pathological staging.</p><p><strong>Methods: </strong>Patients that underwent gastrectomy between 2011 and 2016 were reviewed from the Dutch Upper Gastrointestinal Cancer Audit. Patients with <15 and ≥15 LN retrieved were compared after propensity-score matching based on patient and tumor characteristics. The primary endpoint was 3-year overall survival.</p><p><strong>Results: </strong>A total of 2047 patients were included in the study. After propensity score matching, 522 patients with ≥15 LNs were matched to 522 patients with <15 LNs. There was no statistically significant difference in overall survival between both groups, with 3-year survival rates of 56% versus 59%, respectively. Patients with ≥15 LNs had a more advanced pN-category. While median survival was higher for patients with ≥15 LNs versus <15 LNs in the subgroups pN2, pN3a, and pN3b, no statistically significant differences were found. Similar results were found in the propensity score matched cohort using 23 LNs as cut-off.</p><p><strong>Conclusions: </strong>≥15 LNs retrieved during gastrectomy for cancer was associated with higher pN-stage, likely as a result of stage migration. Three-year overall survival was comparable for patients with ≥15 LNs and patients with <15 LNs retrieved.</p>\",\"PeriodicalId\":11241,\"journal\":{\"name\":\"Digestive Surgery\",\"volume\":\" \",\"pages\":\"1-20\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestive Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000546436\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546436","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
The association between number of retrieved lymph nodes and survival in gastric cancer surgery: a Dutch population-based study.
Background: This study aimed to evaluate whether the retrieval of 15 or more lymph nodes (LN) during gastrectomy for cancer is associated with better survival and more accurate pathological staging.
Methods: Patients that underwent gastrectomy between 2011 and 2016 were reviewed from the Dutch Upper Gastrointestinal Cancer Audit. Patients with <15 and ≥15 LN retrieved were compared after propensity-score matching based on patient and tumor characteristics. The primary endpoint was 3-year overall survival.
Results: A total of 2047 patients were included in the study. After propensity score matching, 522 patients with ≥15 LNs were matched to 522 patients with <15 LNs. There was no statistically significant difference in overall survival between both groups, with 3-year survival rates of 56% versus 59%, respectively. Patients with ≥15 LNs had a more advanced pN-category. While median survival was higher for patients with ≥15 LNs versus <15 LNs in the subgroups pN2, pN3a, and pN3b, no statistically significant differences were found. Similar results were found in the propensity score matched cohort using 23 LNs as cut-off.
Conclusions: ≥15 LNs retrieved during gastrectomy for cancer was associated with higher pN-stage, likely as a result of stage migration. Three-year overall survival was comparable for patients with ≥15 LNs and patients with <15 LNs retrieved.
期刊介绍:
''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.