title: Lymph node pick up by separate stations: Option or necessity.
abstract: OBJECTIVE
  To evaluate whether lymph node pick up by separate stations could be an indicator of patients submitted to appropriate surgical treatment.
  
  
  METHODS
  One thousand two hundred and three consecutive gastric cancer patients submitted to radical resection in 7 general hospitals and for whom no information was available on the extension of lymphatic dissection were included in this retrospective study.
  
  
  RESULTS
  Patients were divided into 2 groups: group A, where the stomach specimen was directly formalin-fixed and sent to the pathologist, and group B, where lymph nodes were picked up after surgery and fixed for separate stations. Sixty-two point three percent of group A patients showed < 16 retrieved lymph nodes compared to 19.4% of group B (P < 0.0001). Group B (separate stations) patients had significantly higher survival rates than those in group A [46.1 mo (95%CI: 36.5-56.0) vs 27.7 mo (95%CI: 21.3-31.9); P = 0.0001], independently of T or N stage. In multivariate analysis, group A also showed a higher risk of death than group B (HR = 1.24; 95%CI: 1.05-1.46).
  
  
  CONCLUSIONS
  Separate lymphatic station dissection increases the number of retrieved nodes, leads to better tumor staging, and permits verification of the surgical dissection. The number of dissected stations could potentially be used as an index to evaluate the quality of treatment received.
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgagni
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Oriana
authors.initials: O
authors.lastname: Nanni
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Carretta
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Altini
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Saragoni
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.affiliation: Paolo Morgagni, Domenico Garcea, Department of General Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Garcea
keywords: Gastric cancer; Lymph node; Lymphadenectomy; Separate station pick up