XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
  Breast
  Skin
  Blood
  Prostate
  Liver
  Colon
  Thyroid
  Endometrial
  Brain
  Therapy
  Risk Factors
  Esophageal
  Bladder
  Lung
  Rectal Cancer
  Pancreatic Cancer
  Bone Cancer
  Cervical Cancer
  Testicular Cancer
  Gastric Cancer
  Ovarian Cancer
  Nerve Tissue
  Renal Cell Carcinoma
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
 
 India
Search

Last Updated: Nov 18, 2006 - 12:32:53 PM

Cancer

Gastric Cancer Channel
subscribe to Gastric Cancer newsletter

Latest Research : Cancer : Gastric Cancer

   DISCUSS   |   EMAIL   |   PRINT
Less than one third gastric cancer patients actually have adequate lymph node assessments
Sep 25, 2006 - 6:38:00 PM, Reviewed by: Dr. Rashmi Yadav

"Education for pathologists, surgeons and medical oncologists should improve ALNA, and by proxy, improve the care received by patients with gastric cancer, and their overall survival."

 
Most patients who undergo gastric cancer staging by lymph node sampling have inadequate assessments that compromise survival, according to a new study. Published in the November 1, 2006 issue of CANCER , a peer-reviewed journal of the American Cancer Society, the study reveals that less than one third of gastric cancer patients had adequate lymph node assessments (ALNA). This had a profound effect on patient survival. Median survival in the region with the highest ALNA rate (53 percent) was 33 months compared to just 17 months in the worst rate (19 percent). A change in the staging system guidelines in 1997 was intended to improve staging of gastric cancers, but made only small improvements in the quality of lymph node assessments.

Appropriate staging of gastric cancer is necessary in order to identify the most appropriate treatments. One of the most important factors in determining the stage of disease is metastasis to the lymph nodes. Lymph node assessment is quite complex, requiring collaboration between the surgeon who resects the lymph nodes and the pathologist who must analyze them. The work of either of these physicians may be impacted by patient characteristics, such as obesity.

Prior to 1997, evidence suggested that the system of staging as put forth by the American Joint Committee on Cancer (AJCC) and Union Internationale Contre le Cancer (UICC) was both improperly and variably used by physicians. To standardize staging methods, new guidelines in 1997 changed the definition of ALNA from distance from primary tumor to the number of lymph nodes with cancer out of at least 15 resected.

With evidence from other cancers showing the importance of staging to prognosis and recent advances in the management of gastric cancers, assessment of the new ALNA staging guidelines is timely. To identify compliance with the guidelines and its impact on survival, Natalie G. Coburn, M.D., M.P.H., an Assistant Professor at Sunnybrook Health Sciences Centre in Toronto and colleagues reviewed data from 10,807 patients with gastric cancers reported in the Surveillance, Epidemiology and End Results (SEER) database.

Compliance with new guidelines remains poor. After 1997 the median number of lymph nodes resected increased from 9 to only 10. Overall, only 29 percent of patients had at least 15 lymph nodes resected, indicating poor compliance by physicians. By SEER region, however, rates varied from 19 to 53 percent. Poor ALNA use in up to 11 percent of patients resulted in the possibility of inappropriately denying them new adjuvant therapy. A few of the factors that predicted use of new ALNA guidelines included the SEER region, Asian ethnicity, advanced disease, type of resection and younger age.

In the SEER region with the highest ALNA rate, median survival was 33 months. In the SEER region with the lowest ALNA rate, median survival fell to 17 months. ALNA improved survival at every stage, with the most significant benefit to patients with early stage disease.

This study, according to the authors, shows that inadequate staging of gastric cancer compromises patient care. "Education for pathologists, surgeons and medical oncologists should improve ALNA," according to Dr. Coburn, "and by proxy, improve the care received by patients with gastric cancer, and their overall survival."
 

- The study is published in the November 1, 2006 issue of CANCER , a peer-reviewed journal of the American Cancer Society.
 

http://www.interscience.wiley.com/

 
Subscribe to Gastric Cancer Newsletter
E-mail Address:

 

Article: "Significant Regional Variation in Adequacy of Lymph Node Assessment and Survival in Gastric Cancer," Natalie G. Coburn, Carol J. Swallow, Alex Kiss, Calvin Law, CANCER; Published Online: September 25, 2006 (DOI: 10.1002/cncr.22229); Print Issue Date: November 1, 2006.

Related Gastric Cancer News

Less than one third gastric cancer patients actually have adequate lymph node assessments
Long term benefits of Imatinib in advanced gastrointestinal stromal tumors (GIST) confirmed
New discoveries to tackle stomach cancer
Stomach cancer formation can be supressed by by lowering Stat3 hyperactivity


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us