A more thorough operation for gastric cancer.Anatomical basis and description of technique

McNeer, Gordon; Sunderland, Douglas A.; McInnes, George F.; VandenBerg, Henry J.; Lawrence, Walter

doi:10.1002/1097-0142(195109)4:5<957::aid-cncr2820040509>3.0.co;2-m

Cited by 55 publications

(13 citation statements)

References 8 publications

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“…As with a total gastrectomy, a double number of lymph nodes was resected compared to partial gastrectomy, he advocated total gastrectomy as radical procedure [15]. McNeer et al [16] in 1951 blamed the nonimprovement of postoperative mortality on the lack of a standardized surgical procedure and designed one for the locoregional anatomy of the stomach. Nevertheless, the effect on 5-year survival was negligible and the complication rate unfavourable [17,18].…”

Section: Historymentioning

confidence: 99%

Status of extended lymph node dissection: Locoregional control is the only way to survive gastric cancer

Hartgrink

Velde

2005

Journal of Surgical Oncology

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There are many factors that are of influence on gastric cancer treatment. The only way to survive is complete locoregional control. More extended dissections should lead to better outcome, but increased morbidity and mortality probably offset its long-term effect in survival in randomised studies. In this article the factors of influence on outcome of gastric cancer treatment such as the extent of lymph node dissection, splenectomy, pancreatectomy, age, volume and additional treatments are discussed. A literature review of these factors in relation to the latest results of the Dutch Gastric Cancer Trials are presented. If morbidity and mortality can be reduced there might be an advantage of extended lymph node dissection. Splenectomy and pancreatectomy should be performed only in case of direct in growth from the tumour into these organs. Centralisation of gastric cancer treatment should be achieved in order to improve results and to facilitate research. By refining selection criteria in the treatment of gastric cancer further improvements are to be expected.

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Section: Historymentioning

confidence: 99%

Status of extended lymph node dissection: Locoregional control is the only way to survive gastric cancer

Hartgrink

Velde

2005

Journal of Surgical Oncology

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“…The monographs, now regarded as classics in oncology, covered the treatment of cancer of all the anatomical regions. While studying how best to carry out a resection for gastric cancer, I read that McNeer et al had thoroughly researched the lymphatic pathway of spread of gastric cancer, and had described the technique and anatomical basis for the radical gastrectomy operation 14,15 . The technical thoroughness and expertise of these pioneering surgeons impressed me, and I strove to apply the principles they described to oncological resection.…”

Section: Oncological Surgery At the University Surgical Unitmentioning

confidence: 99%

A surgeon's look at the treatment of cancer

Shiu

2003

Annals of the College of Surgeons of Hong Kong

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Radical resection of cancer, such as radical mastectomy and abdominoperineal rectal resection, was developed in the last century. Wide-field resection and lymph node dissection formed the basic tenets of these operations. Oesophagectomy, hepatectomy, pancreatectomy and other major resections followed. These surgical endeavours led to some spectacular cures, but also frequent postoperative deaths and complications. Advances in surgical technique and medical science have reduced the risk of surgery to an acceptable level. The last two decades have seen patients presenting with earlier and smaller cancers, prompting reexamination of the basic tenets of oncological resection. Radiotherapy as an adjunct to surgery has reduced the need for wide radical resection of cancer of the breast, rectum and many other sites. Prospective randomized clinical trials have validated the safety of lesser scopes of surgical resection for breast cancer and cutaneous melanoma. The classical radical mastectomy is now seldom carried out. Simple wedge excision (so-called 'lumpectomy') is now the most common operation for breast cancer. Wide radical resection continues to be advocated for cancer of the lung, oesophagus, stomach, and pancreas, but its benefit needs to be confirmed by similar controlled trials. Adjuvant chemotherapy given after resection of breast and colon cancer has proven survival benefit. Chemotherapy can also shrink some bulky, unresectable cancers, making them resectable. Advances in molecular biology have recently allowed the introduction of novel therapeutic agents which can abrogate the growth and progression of some cancers at the molecular level. Technological advances have enabled the development of minimally invasive cancer treatment techniques. Procedures such as radiosurgery, radiofrequency ablation, and video-assisted endoscopic resections can achieve cancer control with minimized risk and morbidity. The new millennium will see continued evolution in the role of surgery in the treatment of cancer.

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“…Before addressing recent randomized trials of the various types of lymphatic dissection used for gastric cancer, it is worthwhile to review earlier information that has led to our bias in the United States towards a more conservative lymphadenectomy. After armchair enthusiasm in earlier years for the potential benefit of extensive lymphadenectomy achieved by routine "extended total gastrectomy" [12], one of us (W.L.) compared the overall results of gastric resection for cancer during two successive time intervals at a major cancer center [13].…”

Section: R3 Resection Means Complete Resection Of the N1mentioning

confidence: 99%

“…R-1 dissection) The second time period was 1950-1955, a period in which more than half of the gastric cancer patients at the same cancer center were treated by an "extended total gastrectomy". This procedure entailed routine resection of the body and tail of the pancreas, and the spleen, in order to remove the secondary orbit of lymph nodes, the so called pancreatolienal nodes [12]. (This operation is appropriately designated as an R-2 resection).…”

Section: R3 Resection Means Complete Resection Of the N1mentioning

confidence: 99%

Guest editorial: “EXTENDED” lymph node dissections for gastric cancer—Is more better?

Lawrence

Horsley

1996

J. Surg. Oncol.

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A more thorough operation for gastric cancer.Anatomical basis and description of technique

Cited by 55 publications

References 8 publications

Status of extended lymph node dissection: Locoregional control is the only way to survive gastric cancer

Status of extended lymph node dissection: Locoregional control is the only way to survive gastric cancer

A surgeon's look at the treatment of cancer

Guest editorial: “EXTENDED” lymph node dissections for gastric cancer—Is more better?

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