Effectiveness of extended lymphadenectomy in noncurative gastrectomy - 12/09/11
Abstract |
Purpose |
We examined the efficacy of extended lymph node dissection for prolonging survival in macroscopically or histologically proven incurable gastric cancer.
Patients and methods |
We analyzed clinicopathologic data on 119 patients with serosally invasive gastric cancer who underwent noncurative gastrectomy, with respect to the relation between the extent of lymphadenectomy and survival benefit.
Results |
The 5-year survival rate was significantly higher among patients treated with extensive lymphadenectomy (R2/3) compared to simple gastrectomy (R1). Extensive lymphadenectomy significantly prolonged survival time even after noncurative gastrectomy in cases where there was no evidence of hepatic metastasis, peritoneal seeding, or extensive nodal metastasis beyond the tertiary lymph node, and regardless of the extent of direct invasion to adjacent organs.
Conclusions |
Gastrectomy combined with extended lymphadenectomy and/or resection of adjacent organs is recommended for gastric cancer patients without distant metastasis, even when the operation is histologically noncurative.
Gastrectomy and perioperative intensive chemotherapy are called for when patients have distant metastasis.
Le texte complet de cet article est disponible en PDF.| * | The concept of a significant but noncurative reduction in tumor mass continues to float in and out of the surgical and oncologic literature. This interesting paper suggests that extended nodal dissection has some survival benefit in advanced gastric cancer even when the operation cannot be curative. The implications may far exceed the continuing detailed Japanese experience with gastric cancer. |
Vol 169 - N° 2
P. 261-264 - février 1995 Retour au numéro
Article précédent
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- Tilman T. Zittel, Björn von Elm, Robert K. Teichmann, Helen E. Rabould, Horst D. Becker
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