Gastric cancer: which patients benefit from systematic lymphadenectomy?

Bösing, N.; Pe, Goretzki; Röher, H.-D.

doi:10.1053/ejso.1999.0930

Cited by 18 publications

(6 citation statements)

References 20 publications

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“…However, there has been no prospective study that shows that the extended D2 lymphadenectomy has a survival benefit over limited D1 lymphadenectomy, although some analyses have shown that long-term survival could be improved by D2 dissection [8][9][10][11][12][13], especially for some tumor stages [14][15][16][17][18][19]. The rationale of D2 lymphadenectomy is mainly based on the fact that tier 2 stations are frequently involved and that a considerable number of patients with metastasis in those stations survive for a long time after radical surgery [20].…”

Section: Discussionmentioning

confidence: 99%

Modified radical lymphadenectomy (D1.5) for T2–3 gastric cancer

Ichikura

Chochi

Sugasawa

et al. 2005

Langenbecks Arch Surg

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Background: The operative mortality in gastric cancer surgery has been reported to be higher with D2 lymphadenectomy than with D1 in the West. The modified radical lymphadenectomy (D1.5) may be safer than D2 under these circumstances. This study was aimed to determine whether D1.5 would deteriorate long-term survival as compared with D2. Method: Since the concept of the extent of lymphadenectomy varied among the surgeons, 461 patients who underwent curative gastrectomy for T2-4 gastric adenocarcinoma were retrospectively categorized into three groups according to the surgeon: D1 with dissection along the left gastric and common hepatic arteries (D1.5); lymphadenectomy between D1.5 and D2; D2 or more extended dissection. Results: No differences were found in the survival rates among the three groups within each of the T2a, T2b, and T3 categories. According to a multivariate analysis using Cox's proportional hazard model, the classification according to the surgeons had no survival impact (p>0.8). Conclusion: D1.5 lymphadenectomy resulted in a survival rate that was almost equal to that of D2. The use of D1.5 instead of D2 can be an attractive option to be compared with D1 in future trials.

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Section: Discussionmentioning

confidence: 99%

Modified radical lymphadenectomy (D1.5) for T2–3 gastric cancer

Ichikura

Chochi

Sugasawa

et al. 2005

Langenbecks Arch Surg

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“…Surgical morbidity in gastric cancer surgery is reported to be as high as 39% [5] . In addition, complications after curative surgery for gastric cancer have a negative effect on overall and disease specific survival [6] .…”

Section: Advances In Preoperative Carementioning

confidence: 99%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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“…wiley.com.] mortality rates between 3% and 8%, morbidity rates between 22% and 38%, and 5-year survival rates between 26.3% and 55% for D2 dissections (Table II) [34][35][36][37][38][39][40]. The variability in outcomes is substantial, likely because of the different definitions of D2 dissections in most series and the abandonment of pancreatico-splenectomy in later series.…”

Section: Surgerymentioning

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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Gastric cancer: which patients benefit from systematic lymphadenectomy?

Cited by 18 publications

References 20 publications

Modified radical lymphadenectomy (D1.5) for T2–3 gastric cancer

Modified radical lymphadenectomy (D1.5) for T2–3 gastric cancer

Improving the outcomes in gastric cancer surgery

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

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