What are Lymph Nodes (LN)?
Lymph nodes (LN) are small, bean-shaped organs found throughout the body. They have many important roles as a part of the immune and cardiovascular systems. Unfortunately, LN are a common secondary site of cancer. This is especially true in gastric cancer, because the LN near the stomach are clustered together in close bunches near many blood vessels. These bunches are connected to each other by small canals, making an easy path for the disease to spread. Removing lymph nodes can help to prevent the spread of cancer. This is why it is important that they are removed in gastric cancer surgery. The N-stage in TNM tumor staging tells us the number of LN that have developed cancer.
What is a lymphadenectomy?
- D1: this surgery is less extensive. It only takes out the LN found closest to the stomach.
- D2: this surgery is more extensive. It takes out the LN found closest to the stomach, as well as LN found close to major blood vessels.
Why are LN important?
There are a number of unanswered questions about the role of LN in gastric cancer surgery. Dr. Coburn’s work shows that sometimes there is not enough information available for surgeons to know how many LN to remove to keep their patients healthy, especially in North America.
Not removing enough LN can mean a few things for the patient:
- Some of the cancer is still left in the body
- It can be hard to tell how far the cancer has spread from the primary site
These important issues are addressed in the studies below.