STARD: How many lymph nodals needed to be dissected in corpus carcinoma?

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Abstract

During corpus carcinoma surgery, there is uncertainty as to how many lymph nodes should be dissected and examined to determine lymph invasion.

In this study, we evaluated a beta-binominal model in data extracted from the Surveillance, Epidemiology, and End Results (SEER) database, which contains 22,372 complete records. We quantified the relationship between examined node number and the probability of missing invaded nodes. Survival curves were used for further validation.

We found that for stage T1-T4, 1, 10, 23, and 37 lymph nodes, respectively, needed to be examined to minimize the missing positive nodal probability (1-nodal staging score, NSS) to less than 5%. A hypothetical lymph node examination rate was calculated. Survival rate of T2 and T3 stage samples was significantly associated with NSS, but T1 and T4 sample survival rate was not.

The currently dissected nodal should be reduced to 1 to 2 for T1, remains to 10 for T2, and increases to 23 for T3.

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