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Long-term survival is improved by an extended lymph node dissection in potentially curable gastric cancer
Erhan Reis1, Nuri Aydin Kama, Mutlu Doganay
1Fourth Department of Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Background/Aims:
This study was planned to investigate the therapeutic value of performing an extended lymphadenectomy in potentially curable gastric cancer.
Methodology:
A prospective gastric cancer database was used. In total 114 gastric cancer patients (85 male, 29 female) who underwent a gastrectomy for curative intent from 1992 through 1999 were included to this study. Morbidity and mortality, survival rates and factors affecting survival were evaluated.
Results:
Sixty-six (58%) patients had limited (D1) and 48 (42%) patients had extended (D2) gastric resections. The operative mortality rates were 12% and 8% and the postoperative complication rates were 33% and 25% in the D1 and D2 lymphadenectomy patients, respectively. The mean follow-up period was 34 (range: 8-94) months. The overall mean survival was 32 months (25 months in D1 group, 46 months in D2 group) (P < 0.05). The duration of symptoms, the presence of postoperative complications, the extent of lymphadenectomy, the operative curability and the site of the tumor were all found to be independent prognostic factors based on a multivariate analysis.
Conclusions:
This study demonstrates that an extended lymph node dissection improves long-term survival without increasing postoperative morbidity and mortality in patients with potentially curable gastric cancer.