[Systematic lymphadenectomy in stomach carcinoma--staging and therapy]

The diagnostic and therapeutic relevance of systematic (D2-) lymphadenectomy was studied in 440 resections for primary gastric carcinoma. A total of 13910 lymph nodes (mean: 31.6 (15.3)) was resected with 3716 being metastatic (mean: 8.6 (11.0)). During surgery 24% of the carcinomas were incorrectly staged when compared with the pathological stage. The prognosis was influenced by tumor stage, R-classification and number of lymph node metastases. Patients with a maximum of three metastases and R0-resection had a prognosis not significantly different from patients with pN0-stage (5-year-survival: 77% and 64% resp.; p = 0.21). Systematic lymphadenectomy in gastric carcinoma has not only diagnostic, but also therapeutic importance in patients with limited lymph node metastases.