Eficácia da solução reveladora de linfonodos em peças de gastrectomia com linfadenectomia por adenocarcinoma gástrico

Siqueira, Pablo R.; Nadal, Sidney Roberto; Santo, Giulio Cesare; Silva, Marcos Mota da; Rodrigues, Francisco; Malheiros, Carlos Alberto

doi:10.1590/s0100-69912000000400001

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…There was a change in stage grouping in four cases (13.3%). Luebke et al (20) and Siqueira et al (29) did not observe changes in pN staging, but the number of cases in their study was small. Koren et al (13) observed a change in pN staging in six out of 10 cases studied (60%), however, the average of LNs achieved (three LNs/case) was very low by CM, increasing considerably after using LRS, probably explaining the pN change.…”

Section: Discussionmentioning

confidence: 72%

“…In Brazil, a study conducted by the Grupo de Estômago e Duodeno do Departamento de Cirurgia e Departamento de Ciências Patológicas da Faculdade de Ciências Médicas da Santa Casa de São Paulo used LRS in 13 gastrectomy pieces, finding 222 LNs by CM (mean of 17.07 LNs/case) and, after using LRS, they found 123 more LNs (mean of 9.46 LNs/case) (29) , an increase of 55.5%.…”

Section: Discussionmentioning

confidence: 99%

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Impact of using a lymph node revealing solution in surgical specimens for pathological staging of gastric cancer

Sousa¹,

Savassi-Rocha²,

Cabral³

2014

Jornal Brasileiro De Patologia E Medicina Laboratorial

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Introduction: Lymph node (LN) metastasis is a major staging criterion of gastric cancer (GC). GC prognosis is associated with the number of metastatic LNs. Objective: To evaluate the impact of using a lymph node revealing solution (LRS) in gastrectomy specimens. Material and methods: prospective study in 30 gastrectomy specimens (19 men, average age of 59.5; 11 women, average age of 66.1) for pathological tumor, node, metastasis (TNM) staging. After LN dissection according to the routine procedures (conventional method [CM]), the tissue was emerged in LRS: a mixture containing 65% ethanol, 20% ether, 5% acetic acid, and 10% formalin solution (10%), for 36 hours with 3 changes. A new LN dissection was performed. The number of LNs obtained from both methods was compared and analyzed. The number of metastatic and non-metastatic LNs was determined. Results: From 1,005 (33.5/specimen) dissected LNs, 657 of which (21.9/specimen) by the CM, and 348 (11.6/specimen) after using LRS (p = 0.0002), metastases were detected in 272 LNs (9.2/case), 211 of which (7.0/specimen) were found with the CM, and 61 (2.0/specimen) after using LRS (p = 0.0028). The number of LNs increased 53.0% with LRS, and the number of metastatic LNs was 28.9% higher. The pN classification changed in 5 (16.7%) of the 30 specimens, and in stage grouping in 4 (13.3%) analyzed cases. Conclusion: The use of LRS in gastrectomy specimens is simple, enables dissection, increases the number of LNs, and occasionally changes pN staging and stage grouping.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Impact of using a lymph node revealing solution in surgical specimens for pathological staging of gastric cancer

Sousa¹,

Savassi-Rocha²,

Cabral³

2014

Jornal Brasileiro De Patologia E Medicina Laboratorial

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Carnoy’s solution increases the number of examined lymph nodes following gastrectomy for adenocarcinoma: a randomized trial

et al. 2014

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Background Pathological examination of a minimum of 16 lymph nodes is recommended following surgery for gastric adenocarcinoma, despite this a longer survival is expected when 30 or more lymph nodes are examined. Small lymph nodes are difficult to identify, and fat-clearing solutions have been proposed to improve this, but there is no evidence of their clinical benefit. Methods Fifty D2 subtotal gastrectomy specimens were randomized for fixation in Carnoy's solution (CS) or 10 % neutral buffered formalin (NBF), with subsequent fat dissection. After dissection, the residual fat from the NBF group, instead of being discarded, was immersed in CS and dissected again. Data from 25 D2 subtotal gastrectomies performed before the study were also analyzed. Results The mean number of examined lymph nodes was 50.4 and 34.8 for CS and NBF, respectively (p \ 0.001). Missing lymph nodes were found in all cases from the residual fat group (mean of 16.9), and in eight of them (32 %) metastatic lymph nodes were present; this allowed the upstaging of two patients. Lymph nodes in the CS group were smaller than those in the NBF group (p = 0.01). The number of retrieved lymph nodes was similar among the NBF and Retrospective groups (p = 0.802). Conclusions Compared with NBF, CS increases lymph node detection following gastrectomy and allows a more accurate pathological staging. No influence of the research protocol on the number of examined lymph nodes was observed.

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Eficácia da solução reveladora de linfonodos em peças de gastrectomia com linfadenectomia por adenocarcinoma gástrico

Cited by 2 publications

References 11 publications

Impact of using a lymph node revealing solution in surgical specimens for pathological staging of gastric cancer

Impact of using a lymph node revealing solution in surgical specimens for pathological staging of gastric cancer

Carnoy’s solution increases the number of examined lymph nodes following gastrectomy for adenocarcinoma: a randomized trial

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