Ex vivo lymphadenectomy during gastrectomy for adenocarcinoma optimizes lymph node yield Journal Article


Authors: Afaneh, C.; Levy, A.; Selby, L.; Ku, G.; Tang, L.; Yoon, S. S.; Coit, D.; Strong, V. E.
Article Title: Ex vivo lymphadenectomy during gastrectomy for adenocarcinoma optimizes lymph node yield
Abstract: Introduction: Variability in surgical and pathological techniques in Western centers may lead to inconsistency in lymph node staging in patients with gastric adenocarcinoma. We hypothesize that ex vivo dissection (EVD) after gastrectomy for adenocarcinoma increases lymph node yield. Methods: We retrospectively reviewed 222 consecutive patients who underwent gastrectomy with curative intent for adenocarcinoma between November 2010 and June 2014. In August of 2012, we began performing EVD of nodes in surgical specimens (EVD group, N = 111), as opposed to submitting specimens en bloc with lymph node basins attached to the specimen (No EVD group, N = 111). Primary end point was lymph node yield. Results: The median number of lymph nodes procured was significantly higher in the EVD compared to that in the No EVD group (30 vs. 21 lymph nodes, respectively; P < 0.0001). Moreover, 28 % of the No EVD group were not adequately staged (defined by ≤15 nodes), compared to 5 % of the EVD group (P < 0.0001). Stage-for-stage overall survival was not significantly different. Conclusion: EVD may be a useful tool to maximize lymph node yield. However, this had no impact on staging or survival. This is an interesting finding that warrants further investigation. © 2015, The Society for Surgery of the Alimentary Tract.
Keywords: staging; lymph node; gastrectomy; gastric cancer; ex vivo dissection
Journal Title: Journal of Gastrointestinal Surgery
Volume: 20
Issue: 1
ISSN: 1091-255X
Publisher: Springer  
Date Published: 2016-01-01
Start Page: 165
End Page: 171
Language: English
DOI: 10.1007/s11605-015-2948-3
PROVIDER: scopus
PUBMED: 26403717
PMCID: PMC4862875
DOI/URL:
Notes: Article -- Export Date: 3 February 2016 -- Source: Scopus
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MSK Authors
  1. Sam Yoon
    108 Yoon
  2. Geoffrey Yuyat Ku
    233 Ku
  3. Laura Hong Tang
    448 Tang
  4. Vivian Strong
    268 Strong
  5. Daniel Coit
    542 Coit
  6. Adam S Levy
    3 Levy
  7. Luke   Selby
    21 Selby
  8. Cheguevara I Afaneh
    2 Afaneh