Lymphadenectomy
REGRESSION, DISEASE
The mean number of examined lymph nodes per patients were 44.3 ± 16.7 in OTG and 40.7 ± 16.3 in MITG (Although the intent was to perform a D2 lymphadenectomy in each patient, surgeons were asked to report which stations were actually resected following the procedure. When assessing the reported resected stations, according to the surgeon, adequate D2 resection was performed in 35 patients (71.4%) following OTG and in 35 patients (74.5%) following MITG. Analysis of type of lymphadenectomy per clinical disease stage revealed that a lower clinical stage was associated with not obtaining a D2 lymphadenectomy. In stage I disease, D2 lymphadenectomy was obtained in 36.4% of patients, versus above 70% for stages II and up (Upon pathological examination of these marked stations, lymph nodes were not always identified in the marked stations. When assessing the stations, which actually contained lymph nodes, it seems that only 14 patients (30%) following OTG and 17 patients (36%) following MITG had a complete D2 lymphadenectomy. Further statistical analysis revealed no difference in D2 lymphadenectomy rate per disease stage (Binary logistic regression for predictors of inadequate D2 lymphadenectomy showed that patient factors such as age, gender, BMI, and comorbidities were not associated with obtaining an inadequate pathological D2 lymphadenectomy. Regarding preoperative staging, a clinical N2 staging or higher was associated with a higher odds ratio of obtaining adequate lymphadenectomy (Odds ratio 3.54 with 95% confidence interval 1.079–12.82).