La linfadenectomia estesa nel trattamento del cancro gastrico

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Francesco Milone, Giuseppe Salvatore, Ciro De Martino*, Marco Milone, Luigi Sossio Pezzullo, Martina Pezzullo

Ann. Ital. Chir., 2006; 77: 299-303

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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.

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