In Reply We thank Yang et al for raising questions about our findings from the California Cancer Registry that reveal improved survival among patients with surgically treated gastric cancer. Our findings are compliant with the American College of Surgeons Commission on Cancer quality measure mandating that at least 15 lymph nodes be evaluated.1 Although patients treated at hospitals having approved cancer programs were more likely to have 15 lymph nodes removed, we found that a predictor of survival was compliance with the guideline of the evaluation of at least 15 lymph nodes rather than whether or not cancer programs were approved.1 Yang et al extend this question by considering whether the removal of more than 25 lymph nodes would result in even better survival.
Morgan JW, Ji L, Lum SS. Lymph Node Count as a Quality Measure for Gastric Cancer Surgery—Reply. JAMA Surg. 2015;150(6):596-597. doi:10.1001/jamasurg.2015.0330