Long-Term Outcomes after D2 Gastrectomy for Early Gastric Cancer: Survival Analysis of a Single-Center Experience in China

Abstract

Background: Early gastric cancer (EGC) is well accepted as having a favorable prognosis, but some patients experience an ominous outcome after curative resection. This study was aimed at evaluating predictive factors associated with prognosis of D2 gastrectomies in patients with early gastric cancer. Materials and Methods: A total of 518 patients with early gastric cancer who underwent D2 gastrectomies were reviewed in this study. The clinicopathological features and surgical outcomes were analyzed. The survival rate was estimated using the Kaplan-Meier method and compared by log rank test. Prognostic factors were analyzed using a multivariate Cox proportional hazards model. Results: The 5-year survival rate was 90.3%. Tumor infiltration, lymph node metastasis and lymphovascular invasion were significant prognostic factors for survival. Gender, age, tumor size, tumor location, macroscopic type and histological type were not significant prognostic factors. Multivariate analysis indicated that lymph node metastasis was an independent poor prognosis factor. Conclusions: Early gastric cancers with lymph node metastasis have a relatively poor prognosis after standard surgery. Even after curative resection, patients with EGC with positive lymph nodes should be closely followed and be considered as candidates for comprehensive therapies.

High RNA-Binding Motif Protein 3 (RBM3) Expression is Independently Associated with Prolonged Overall Survival in Intestinal-Type Gastric Cancer

“…Currently, the Japanese gastric cancer protocol recommends D2 radical surgery as a standard surgical resection of gastric cancer, which is widely recognized by more and more international experts and scholars [ 5 – 7 ]. However, for most patients with gastric cancer, even when D2 radical surgery achieves R0 resection, it cannot effectively control the recurrence and metastasis of gastric cancer, and the 5-year survival rate is only 30% [ 8 , 9 ].…”

“…Studies have shown that if gastric cancer can be found in the early stages, the survival rate of patients with gastric cancer can be significantly improved [ 8 , 10 ]. There are many factors that affect the prognosis of gastric cancer, involving many clinical and pathological factors, such as tumor staging, histological differentiation, tumor type, depth and extent of invasion, and with or without metastasis and tumor resection [ 11 – 13 ].…”

Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer

“…[ 1 ] Different from advanced gastric cancer (AGC), EGC had an excellent prognosis, and the 5-year survival rate exceeds 90%. [ 2 ] Therefore, postoperative complication and recovery become a major concern of the surgical outcomes to EGC patients. Laparoscopic surgery results in small incisions, less scarring, and faster recovery and therefore has been widely used for decades for the management of benign diseases.…”

Efficacy of Celiac Branch Preservation in Billroth-Ⅰ Reconstruction After Laparoscopy-Assisted Distal Gastrectomy

“…A study in 2014 revealed that the 5-y survival frequency of dissection 2 (D2) gastrectomy was over 90% in China. 1 Hence, it became necessary to improve postoperative quality of life. As a result, various limited procedures including vagus nerve sparing can be performed.…”