Resection of XXXX should include nodal sampling.

@entity1 @entity5 @entity704 @entity3
OBJECTIVE: @entity704 is best treated by surgical resection; however, no clear guidelines have been created regarding lymph node sampling at the time of resection. Additionally, the prognostic implications of nodal @entity3 are unclear. The aim of this study was to analyze the prognostic implications of nodal @entity3 in @entity704 . METHODS: The Surveillance, Epidemiology, and End Results database was queried for @entity1 who underwent surgical resection of @entity704 with documented pathologic examination of lymph nodes. The impact of nodal status on survival and @entity704 staging was examined. RESULTS: We identified 442 @entity1 who underwent @entity704 resection with pathologic evaluation of 1 or more  lymph nodes. A median of 2 nodes were sampled per @entity1 . Fifty-nine @entity1 (59 of 442, 13.3%) had >= 1 positive node. @entity1 with positive nodes were younger and had smaller @entity5 than node-negative @entity1 . Median survival in the node-positive @entity1 was 98 months, compared with 144 months in node-negative @entity1 (P  =  .013). In multivariable analysis, the presence of positive nodes had a significant, independent, adverse impact on survival (hazard ratio 1.945, 95% confidence interval 1.296-2.919, P  =  .001). The presence of nodal @entity3 resulted in a change in classification to a higher stage in 80% of @entity1 , the majority from Masaoka-Koga stage III to stage IV. CONCLUSIONS: Nodal status seems to be an important prognostic factor in @entity1 with @entity704 . Until the prognostic significance of nodal @entity3 is better understood, surgical therapy for @entity704 should include sampling of regional lymph nodes.
