The extended lymphadenectomy in the treatment of gastric cancer

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.