La linfadenectomia estesa nel trattamento del cancro gastrico
Francesco Milone 1, Giuseppe Salvatore 1, Ciro De Martino 1, Marco Milone 1, Luigi Sossio Pezzullo 2, Martina Pezzullo 2
Affiliations
Article Info
1 Università degli Studi di Napoli “Federico II”, Dipartimento di Scienze Chirurgiche Ortopediche Traumatologiche ed Emergenze, Area Funzionale di Chirurgia Generale, Napoli
2 ASL BN1, P.O. “Maria delle Grazie”, U.O di Chirurgia Generale, Benevento
Abstract
INTRODUCTION: The only potentially curative modality of localized gastric cancer is surgery. However there is area of disagreement among surgeons with respect to the appropriate extent of lymphadenectomy. Methods: The retrospective study of a personal experience on 155 patients with gastric cancer; the patients were divided in two groups with respect to the extent of lymphadenectomy. RESULTS: The results of this study highlight the more effectiveness of D2 resection compared with D1 resection with respect to 5th years survival. DISCUSSION: The goal of treatment is to reduce the risk of recurrent disease. There is considerable debate as to whether the routine use of an extensive en-bloc resection of second echelon lymph nodes (D-2 resection) is superior to a more limited lymphadenectomy of the perigastric lymph nodes (D-1 resection). Therefore the survival benefit of D2 dissection appears to be limited to N2 disease. CONCLUSION: Since nodal status prediction before or during surgery is inaccurate, all patients with curable disease, including those with N0 or N1 disease, should undergone extensive node dissection.
Keywords
- Extended lymphadenectomy
- Gastric cancer
