Stage Migration of Gastric Cancer According to the Extent of Lymph Node Dissection

ABSTRACT

PURPOSE: In this study, the authors attempted to evaluate the stage migration phenomenon according to D1 lymphadectomy and D2 lymphadectomy in the same patients. METHODS: A retrospective study was performed in 300 consecutive patients with gastric cancer who had undergone curative resection with nodal yields of D2 or more from 1994 to 1997. The lymph node status was evaluated in two different extents. Group B included patients with whole harvested regional lymph nodes (D2<) while group A include patients with perigastric lymph nodes (D1). Each group was staged by the number of involved lymph nodes according to the UICC-TNM stage (5th), and by the ratio of involved to resected lymph nodes. Stage migration and the difference of 5YSR were observed between the two groups. RESULTS: In staging by the number of involved lymph nodes, 25 cases (8.3%) of group B were staged up. According to the status by the ratio of involved lymph nodes, 14 cases (4.6%) of group B were staged up and 28 (9.3%) were staged down. CONCLUSION: In the staging of gastric cancer, adequate lymph node dissection was essential for accurate lymph node staging. In the cases of limited lymph node dissection, some extent of stage migration was considered assessing in the prognosis.