Poor Staging Adversely Affects Gastric Cancer Survival

Researchers find that only 29 percent of patients are receiving adequate lymph node assessments

WEDNESDAY, Sept. 27 (HealthDay News) -- Despite 1997 American Joint Commission on Cancer (AJCC) guidelines recommending the resection of at least 15 lymph nodes in patients with gastric cancer, fewer than one-third of such patients are receiving adequate lymph node assessments. Poor staging methods are compromising survival, according to a study published online Sept. 25 in Cancer.

Natalie G. Coburn, M.D., M.P.H., of Sunnybrook Health Sciences Centre in Toronto, Canada, and colleagues reviewed data from the Surveillance, Epidemiology and End Results (SEER) database on 10,807 patients.

Since 1997, the researchers found that the median number of lymph nodes resected has increased from nine to only 10, and that only 29 percent of patients had at least 15 lymph nodes resected. When the researchers compared the nine SEER regions, they found that median survival in the region with the highest guideline compliance rate (53 percent) was 33 months compared to 17 months in the region with the lowest rate (19.7 percent).

"Reasons for non-compliance with the AJCC guidelines need to be further assessed," the authors conclude. "Understanding the current care and outcomes of gastric cancer in a generalizable, population-based setting is a critical first step. Education for pathologists, surgeons, and medical oncologists should improve adequate lymph node assessment and, by proxy, improve the care received by patients with gastric cancer and their overall survival."

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