- TUESDAY, July 22 (HealthDay News) — Patients with stomach or
pancreatic cancer may have more lymph nodes examined for the spread of
cancer if they're treated at designated comprehensive cancer centers or at
hospitals that do a high number of cancer surgeries, says a U.S.
study.

If too few lymph nodes are examined for cancer cells, a patient's
cancer may be incorrectly classified, altering prognosis, treatment
decisions and eligibility for clinical trials, according to background
information in the study. Current guidelines for stomach and pancreatic
patients recommend examination of at least 15 regional lymph nodes.

The researchers examined National Cancer Data Base records of 3,088
stomach cancer patients and 1,130 pancreatic cancer patients. Of the
stomach cancer patients, 11.6 percent had surgery at a hospital designated
as a National Cancer Institute (NCI) comprehensive cancer center or as
part of the National Comprehensive Cancer Network (NCCN-NCI hospitals), 34
percent had surgery at other academic hospitals (affiliated with a medical
school but not designated as NCCN-NCI facilities), and 54.4 percent had
surgery at community hospitals.

Of the pancreatic cancer patients, 19 percent had surgery at NCCN-NCI
hospitals, 43.3 percent at other academic hospitals, and 37.7 percent at
community hospitals.

“Patients undergoing surgery had more lymph nodes examined at NCCN-NCI
hospitals than at community hospitals [median [midpoint], 12 vs. six for
gastric cancer and nine vs. six for pancreatic cancer],” wrote Dr. Karl Y.
Bilimoria, of the American College of Surgeons and Feinberg School of
Medicine at Northwestern University in Chicago, and colleagues. “Patients
at the highest-volume hospital had more lymph nodes examined than patients
at low-volume hospitals [median, 10 vs. six for gastric cancer and eight
vs. six for pancreatic cancer].”

Overall, 23.2 percent of stomach cancer patients and 16.4 percent of
pancreatic cancer patients had at least 15 lymph nodes evaluated, the
study said. Patients at high-volume or NCCN-NCI hospitals were more likely
to have at least 15 lymph nodes examined than patients at community or
low-volume hospitals.

The study was published in the July issue of the Archives of
Surgery.

“Nodal status is a powerful predictor of outcome, and every reasonable
attempt should be made to assess the optimal number of lymph nodes to
accurately stage disease in patients with gastric [stomach] and pancreatic
cancer,” the researchers wrote. “Moreover, differences in nodal evaluation
may contribute to improved long-term outcomes at NCCN-NCI centers and
high-volume hospitals for patients with gastric and pancreatic
cancer.”

More information

The American Cancer Society has more about stomach cancer.