title: Comparison of lymph node number and prognosis in gastric cancer patients with perigastric lymph nodes retrieved by surgeons and pathologists.
abstract: OBJECTIVE
  To compare the numbers of positive and total lymph nodes and prognosis in gastric cancer patients whose perigastric lymph node retrieval was performed by surgeons and pathologists.
  
  
  METHODS
  We conducted a retrospective analysis of clinical and follow-up data from 1, 056 patients who underwent gastric cancer D2 radical lymph node resection between January 2008 and December 2010 in the Gastrointestinal Surgery Department of Yantai Yuhuangding Hospital. The follow-up ended in December 2015. Patients were divided into two groups according to the specialty of physicians who performed the postoperative perigastric lymph node retrieval: the surgeon group (475 cases) and the pathologist group (581 cases). The numbers of positive and total perigastric lymph nodes and the 3- and 5-year survival were compared between gastric cancer patients in the two groups overall and stratified by TNM stage (the 7th Edition of the American Joint Committee on Cancer).
  
  
  RESULTS
  Overall, the numbers of positive and total lymph nodes were significantly higher in the surgeon group than in the pathologist group (6.53±4.07vs. 4.09±3.70, P=0.021; 29.64±11.50vs. 20.71±8.56, P<0.001). Further analysis showed that the total number of lymph nodes in stage I patients (19.40±9.62vs. 15.45±8.59, P=0.011) and the numbers of positive and total lymph nodes in stage II (1.38±1.08vs. 0.87±1.55, P=0.031; 25.35±10.80vs. 16.75±8.56, P<0.001) and stage III patients (8.11±6.91vs. 6.66±5.12, P=0.026; 32.34±12.55vs. 25.45±8.31, P<0.001) were significantly higher in the surgeon group than in the pathologist group. The survival analysis showed that the 3- and 5-year survival of stage II and III patients was significantly higher in the surgeon group than in the pathologist group (82.0%vs. 73.1%, 69.5%vs. 61.2%, P=0.038; 49.2%vs. 38.9%, 36.3%vs. 28.0%; P=0.045).
  
  
  CONCLUSIONS
  Compared with retrieval performed by pathologists, postoperative perigastric lymph node retrieval performed by surgeons was associated with significant increase in the total lymph node number of stage I patients, the numbers of positive and total lymph nodes of stage II and III patients, and the survival of stage II and stage III gastric cancer patients.
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Zengwu
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Jinchen
authors.initials: J
authors.lastname: Hu
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Huiyuan
authors.initials: H
authors.lastname: Zhai
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Xixun
authors.initials: X
authors.lastname: Wang
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Gastrointestinal Surgery Ward I, Yantai Yuhuangding Hospital, the Affiliated Hospital of Qingdao University, Yantai 264000, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
keywords: Gastric cancer; lymph node retrieval; prognosis; surgeon and pathologist