P70 Stage migration in a surgical trial

Impact on survival of the number of lymph nodes removed in patients with node-negative gastric cancer submitted to extended lymph node dissection

“…The factors associated with better disease-free survival at univariate analysis were age <60, T2 tumours, distal location, intestinal histotype, and number of retrieved nodes >25, whereas in our study disease-free and overall survival were similar in patients having [16][17][18][19][20][21][22][23][24][25] or >25 nodes removed. In this study depth of infiltration and histotype were the only 2 independent predictors of 5-year recurrence-free survival at multivariate analysis (35).…”

“…The Japanese Research Society for the Study of Gastric Cancer (JRSGC) strongly recommends extended lymphadenectomy, although it is still unclear, in terms of high level scientific evidence, whether this procedure improves survival or merely refines staging (20,21). It is well known that overall survival rates after radical surgical treatment for gastric cancer at Western and Japanese institutions differ substantially.…”

Safety and application of laparoscopic gastrectomy for benign gastric disease and gastric cancer

“…In Japan, where gastric cancer is six times more common than the West, an extended dissection with routine involvement of D2 and D3 lymph nodes is performed because of perceived improved long-term survival, despite the higher postoperative morbidity and mortality. [15][16][17][18] In contrast, a more conservative lymphadenectomy (D1) is favoured in the West due to the higher complications associated with extended lymphadenectomy (D2, D3) [19][20][21][22] and owing to a paucity of long-term survival data following extensive lymph node resections. [23][24][25] Goh et al 26 are credited with the first laparoscopic-assisted distal gastrectomy in 1992.…”