ArticleFrontiers in oncology2020
Importance of Examined Lymph Node Number in Accurate Staging and Enhanced Survival in Resected Gastric Adenocarcinoma-The More, the Better? A Cohort Study of 8,696 Cases From the US and China, 2010-2016.
Article in Frontiers in oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Safety and Efficacy of Carbon Nanoparticle-Labeled Lymph Node Dissection in Radical Resection of Gastric Cancer: A Systematic Review and Meta-Analysis.Technology in cancer research & treatmentPooled it
- Optimizing gastric cancer treatment: the role of LODDs in lymph node staging.Frontiers in oncology · 2026Article
- Examining more than 35 lymph nodes improves the staging and survival in resectable advanced gastric cancer: a multi-institutional study in China.Surgery today · 2025Observational
- Targeted therapy and immunotherapy for gastric cancer: rational strategies, novel advancements, challenges, and future perspectives.Molecular medicine (Cambridge, Mass.) · 2025Review
- Prognostic performance of examined lymph nodes, lymph node ratio, and positive lymph nodes in gastric cancer: a competing risk model study.Frontiers in endocrinology · 2025Article
- The impact of the number of lymph nodes removed with D2 lymph node dissection on survival in gastric cancer.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Tumor Characteristics and D2 Lymph Node Involvement in Gastric Cancer: A Clinicopathological Analysis (2018-2023) :.Galen medical journal · 2025Article
- 1657 Resected Gastric Adenocarcinomas at a Single Institution: Outcomes and Trends over 17 Years.Annals of surgical oncology · 2024Article
- Article
- Survival Outcome of Gastric Signet Ring Cell Carcinoma Based on the Optimal Number of Examined Lymph Nodes: A Nomogram- and Machine-Learning-Based Approach.Journal of clinical medicine · 2023Article
- Impact of examined lymph node number on accurate nodal staging and long-term survival of resected Siewert type II-III adenocarcinoma of the esophagogastric junction: A large population-based study.Frontiers in oncology · 2022Article
- Continuous care needs in patients with cancer receiving chemotherapy during the recent omicron wave of COVID-19 in Shanghai: A qualitative study.Frontiers in psychology · 2022Article
- Bone Metastasis From Gastric Adenocarcinoma-What Are the Risk Factors and Associated Survival? A Large Comprehensive Population-Based Cohort Study.Frontiers in oncology · 2022Article
- Editorial: The use of chemotherapy in treating gastric cancers.Frontiers in oncology · 2022Article
- Brain metastasis from gastric adenocarcinoma: A large comprehensive population-based cohort study on risk factors and prognosis.Frontiers in oncology · 2022Article
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4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile most guidelines advocate D2 lymphadenectomy for non-metastatic gastric adenocarcinoma (nmGaC), it is not always performed as standard of care outside East Asia. The recommended minimal examined lymph node (ELN) count in nmGaC to stage cancer accurately varies largely across guidelines, and the optimal count to satisfactorily stratify patient survival has yet to be determined. This large cohort study aimed at robustly defining the minimal and optimal thresholds of examined lymph node (ELN) number in non-metastatic gastric adenocarcinoma (nmGaC).
methodsData on nmGaC patients operated in 2010-2016 and surviving ≥3 months were retrieved from the US SEER-18 Program and a Chinese multi-institutional gastric cancer database (MIGC). The correlation of ELN count with stage migration and patient survival were quantified with the use of the multivariable-adjusted logistic and proportional hazards Cox models, respectively. The sequences of odds ratios (ORs) and hazard ratios (HRs) for each additional ELN were smoothed, and the structural breakpoints were determined.
resultsTogether 7,228 patients from the US and 1,468 from China were analyzed, encompassing 23,114 person-years of follow-up. The mean ELN count was 20 in the US and 30 in China. With more ELNs, both cohorts significantly showed proportional increases from lower to higher nodal stage (OR
conclusionIn resected nmGaC patients with anticipated survival ≥3 months, more ELNs are correlated with more accurate staging, which may partly explain the survival correlation. This observational investigation does not indicate causality. Our findings robustly conclude 17 ELNs as the minimum and propose 33 ELNs as the optimum thresholds, to assess the quality of lymph node examination and to stratify postsurgical survival.
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