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- Title
Pathologic Lymph Node Staging of Gastric Cancer.
- Authors
Arco, Cristina Díaz del; Medina, Luis Ortega; Muñoz, Lourdes Estrada; Heras, Soledad García Gómez de las; Aceñero, M Jesús Fernández; Díaz Del Arco, Cristina; Ortega Medina, Luis; Estrada Muñoz, Lourdes; García Gómez de Las Heras, Soledad; Fernández Aceñero, M Jesús
- Abstract
<bold>Objectives: </bold>The TNM classification is the main tool for lymph node (LN) staging in gastric cancer (GC). However, alternative LN staging systems have been proposed, and the role of features other than the number of metastatic LNs is being investigated. Our aim is to discuss the main challenges of LN assessment in GC.<bold>Methods: </bold>Comprehensive review of the literature on alternative LN staging systems, examined LNs, sentinel LN (SLN) biopsy, LN micrometastases (LNMIs), extracapsular extension (ECE), and tumor deposits (TDs) in GC.<bold>Results: </bold>Many controversies exist regarding LN assessment in GC. The TNM classification shows excellent prognostic performance, but alternative prognostic methods such as the LN ratio or log odds of positive LNs have demonstrated to be better than the TNM system in terms of prognostic accuracy. The value of SLN biopsy and LNMIs in GC is still unclear, and several challenges concerning their clinical impact and pathologic analysis must be overcome before their introduction in clinical practice. Most authors have identified ECE and TDs as independent prognostic factors for survival in GC.<bold>Conclusions: </bold>Further studies should be performed to evaluate the impact of these features on the TNM classification and patient outcomes, as well as to standardize alternative LN staging systems.
- Subjects
STOMACH cancer; LYMPH nodes; PROGNOSIS; TUMOR classification; TREATMENT effectiveness; STOMACH tumors; METASTASIS; IMPACT of Event Scale
- Publication
American Journal of Clinical Pathology, 2021, Vol 156, Issue 5, p749
- ISSN
0002-9173
- Publication type
journal article
- DOI
10.1093/ajcp/aqab031