Errors of Surgical Staging in Patients with Cancer of the Stomach

Abstract

A prospective multicentre study including 993 patients with histologically proven gastric cancer who had resections or gastrectomies was started at 11 university depts. of surgery and 11 affiliated hospitals of surgery together with 14 depts. of pathology to get information on the type and amount of errors in surgical staging. Surgeons made their statements, during operation, on multiplicity, location, depth of invasion, Borrmann type of primary tumour, and the degree of lymph-node involvement, independently of the pathologists. No difference was found between surgeons and pathologists concerning multiplicity and location of primary. Concerning Borrmann type there were more false-positive than false-negative choices, whereas for depth of infiltration of primary and lymph-node involvement there were more false-negative than false-positive choices. As a result of this study a histology-oriented surgical approach with standardized frozen sections of the primary, lymph nodes, and resection lines during operation seems mandatory.

Key Words:

• Gastric cancer
• multicentre
• observational study
• staging
• TNM classification