Objective  To evaluate the potential clinical value of standardized procedures of fine lymph node sorting from gastric cancer samples after curative resection.

  Methods  Between January 2016 and December 2017, 727 gastric cancer patients who underwent R0 resection in the Tianjin Medical University Cancer Institute and Hospital were retrospectively included and assigned to either the fine lymph node sorting group or regional lymph node sorting group in accordance with the lymph node sorting methods from the tumor samples of all patients. Both the numbers of examined lymph nodes and metastatic lymph nodes were compared between the two groups. Additionally, correlation analyses were performed between the numbers of examined lymph nodes and metastatic lymph nodes in the two groups.

  Results  There was no significant difference in sex, age, or tumor size between the two groups (P > 0.05), indicating that there was comparability between the two groups. The number of examined lymph nodes in the fine lymph node sorting group was significantly higher than that in the regional lymph node sorting group (P < 0.001). Furthermore, the number of examined lymph nodes in the fine lymph node sorting group was much higher than that in the regional lymph node sorting group with the same pT, pN, or pTNM stage (P < 0.001). The number of metastatic lymph nodes in the fine lymph node sorting group was significantly higher than that in the regional lymph node sorting group (P < 0.001). There was a significant positive correlation between the numbers of examined lymph nodes and metastatic lymph nodes in both groups (fine lymph node sorting group r=0.181, P=0.023; regional lymph node sorting group r=0.227, P < 0.001). Additionally, the correlation coefficient between the numbers of examined lymph nodes and metastatic lymph nodes in the fine lymph node sorting group was weaker than that in the regional lymph node sorting group.

  Conclusions  The standard procedures of fine lymph node sorting from tumor samples of gastric cancer may increase the number of examined lymph nodes, accurately provide the postoperative pN stage, reduce the stage migration, and should be applied in clinical standardization.