impact of the number of harvested lymph nodes on the survival of egyptian patients with gastric cancer: middle eastern tertiary center experience

Background: in the present research, we aimed to estimate the effect of the number of resected lymph nodes (ln) on the survival outcomes of patients with resectable gastric cancer; we investigated whether 16 lns remained the optimal threshold and whether a specific subset of patients could benefit from further ln dissected. method: this cohort study included consecutive patients who underwent surgical resection for gastric cancers from the start of 2012 to the end of 2014. demographic, clinic-pathologic, laboratory data (including complete blood picture, renal function tests, liver function tests, c-reactive protein, prothrombin profile, and electrolytes), type of surgery, systemic chemotherapy, treatment, and survival data were retrospectively collected from the patients' files. results: the mean overall survival ± standard error (se) was 23.051 ± 2.249 months with 95% confidence interval (ci) = 18.644-27.459, while the mean diseasefree survival ± se was 20.675 ± 2.414 months with 95% ci = 15.944-25.906. d2 dissection was associated with significantly better os and disease-free survival (p = 0.001 and p = 0.001, respectively). the mean os for the patients with <16 lymph node dissected was 13.480 ± 1.468 with 95% ci = 10.603-16.357; whereas for those patients with <16 lymph nodes dissected, it was 20.738 ± 2.065 with 95% ci = 16.690-24.786 months, log-rank = 8.030 (p = 0.005). conclusion: the benefit of d2 lymphadenectomy, and subsequently dissecting more lns, still remains under question; however, if morbidity and mortality are kept at a minimum level, d2 dissection could be advantageous. our study concluded that harvesting further lns was associated with more survival benefit.