Introduction: The aim of this study was to define and investigate the prognostic impact of "R1-Lymph-node dissection" during gastrectomy.Methods: This was a retrospective study conducted with 499 patients undergoing curative-aim gastrectomy. We defined R1-Lymph dissection as an involvement of lymph node stations anatomically connected with lymph node stations outside the declared level of dissection (D1 to D2+). The primary outcomes were disease-free and disease-specific survival (DFS and DSS).Results: At multivariable analysis, the type of gastrectomy, pT and pN were associated with DFS, and the type of gastrectomy, R1-Margin status, R1-Lymph status, pT, pN and adjuvant therapy were associated with DSS. Moreover, pT and R1-Lymph status were the only factors associated with overall loco-regional recurrence. Conclusions: In this study, we introduced the concept of R1-Lymph-node dissection, which was significantly associated with DSS and appeared to be a stronger prognostic factor for loco-regional recurrence than the R1 status on the resection margin.
Biondi, A., Agnes, A., Laurino, A., Moretta, P., Lorenzon, L., D'Ugo, D., Persiani, R., The definition of “R1” lymph node dissection status in patients undergoing curative-aim gastrectomy for gastric carcinoma: A proof of concept study, <<SURGICAL ONCOLOGY>>, 2023; 48 (giugno): 1-11. [doi:10.1016/j.suronc.2023.101908] [https://hdl.handle.net/10807/275000]
The definition of “R1” lymph node dissection status in patients undergoing curative-aim gastrectomy for gastric carcinoma: A proof of concept study
Biondi, Alberto;Agnes, Annamaria;Moretta, Pasquale;Lorenzon, Laura;D'Ugo, Domenico;Persiani, Roberto
2023
Abstract
Introduction: The aim of this study was to define and investigate the prognostic impact of "R1-Lymph-node dissection" during gastrectomy.Methods: This was a retrospective study conducted with 499 patients undergoing curative-aim gastrectomy. We defined R1-Lymph dissection as an involvement of lymph node stations anatomically connected with lymph node stations outside the declared level of dissection (D1 to D2+). The primary outcomes were disease-free and disease-specific survival (DFS and DSS).Results: At multivariable analysis, the type of gastrectomy, pT and pN were associated with DFS, and the type of gastrectomy, R1-Margin status, R1-Lymph status, pT, pN and adjuvant therapy were associated with DSS. Moreover, pT and R1-Lymph status were the only factors associated with overall loco-regional recurrence. Conclusions: In this study, we introduced the concept of R1-Lymph-node dissection, which was significantly associated with DSS and appeared to be a stronger prognostic factor for loco-regional recurrence than the R1 status on the resection margin.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.