Journal of Gastrointestinal Surgery

, Volume 13, Issue 7, pp 1233–1237 | Cite as

Factors Influencing Lymph Node Recovery from the Operative Specimen after Gastrectomy for Gastric Adenocarcinoma

  • Scott J. Schoenleber
  • Thomas Schnelldorfer
  • Christina M. Wood
  • Rui Qin
  • Michael G. Sarr
  • John H. Donohue
Original Article

Abstract

Background

Regional lymph node metastases are an important predictor of survival for patients with resectable adenocarcinoma of the stomach. Currently, the number of lymph nodes examined is frequently less than requirements for accurate staging. Clinical factors associated with lymph node recovery are understood poorly.

Methods

We performed a retrospective chart review of 99 consecutive patients who underwent gastrectomy for gastric adenocarcinoma distal to the gastroesophageal junction to determine clinical variables associated lymph node recovery.

Results

Ninety-nine patients underwent gastrectomy for gastric adenocarcinoma at our two hospitals. More than 15 lymph nodes were examined in 64% of specimens. Univariate analysis showed an association between the number of lymph nodes recovered and the number of positive nodes, lymphadenectomy extent, hospital, surgeon, and pathology technician (p < 0.001). Multivariate analysis identified the pathology technician as the most important healthcare-related variable contributing to the variation of lymph node recovery, using fixed- (p < 0.001) and random-effects models.

Conclusions

This study suggests that the pathology technician is an important healthcare-related factor influencing lymph node recovery after gastrectomy. In identifying potential areas benefiting from a systems improvements approach, focus on the technical aspects of specimen processing may be of benefit in maximizing the number of lymph nodes recovered.

Keywords

Gastric cancer Lymph nodes Human factors Neoplasm staging 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • Scott J. Schoenleber
    • 1
  • Thomas Schnelldorfer
    • 1
  • Christina M. Wood
    • 2
  • Rui Qin
    • 2
  • Michael G. Sarr
    • 1
  • John H. Donohue
    • 1
  1. 1.Division of Gastroenterologic and General SurgeryMayo ClinicRochesterUSA
  2. 2.Division of BiostatisticsMayo ClinicRochesterUSA

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