Fixation Using Carnoy’s Solution Enables Detection of More Lymph Nodes After Gastrectomy for Gastric Cancer

• Published in: Anticancer research 2021-08, Vol.41 (8), p.3949-3953
• Main Authors: HAN, SANG HYUP, HAN, JEONG HEE, HAN, SANG HAK, KIM, HAE SUNG, LEE, JIN WON
• Format: Article
• Language: English
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.15191

BACKGROUNDTo compare the number of lymph nodes (LNs) detected when using Carnoy's solution (CS) versus 10% neutral buffered formalin (NBF) to fix specimens after radical gastrectomy for gastric cancer. PATIENTS AND METHODSLNs were routinely detected using NBF until 2020, since then, for the fixation procedure, residual fat was fixed in CS for 24 hours and dissected again for the detection of further LNs. Of 143 specimens, 117 were included in the NBF group and 26 in the CS group. RESULTSThe mean numbers of LNs examined were 27.85±14.89 and 36.30±12.41 in the NBF and CS groups, respectively (p=0.008). The mean number of additional LNs detected using CS was 8.07±2.91, of which 0.38±1.02 were metastatic. Additional LNs were found in all patients of the CS group, and all were ≤3 mm. Of the 26 patients in the CS group, metastatic LNs were detected in four, disease in two of whom was up-staged. CONCLUSIONCS is an appropriate alternative to NBF for the fixation of gastric cancer specimens, and more LNs were detected in the resected specimens fixed when using CS compared with NBF.