Guidelines for Extended Lymphadenectomy in Gastric Cancer: A Prospective Comparative Study

Aims To assess the efficacy of extended lymph node dissection in gastric cancer and to identify factors affecting lymph node detection. Methods A prospective study of 126 gastric cancer patients was conducted. Patients eligible for curative resection received total gastrectomy and extended lymphaden...

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Bibliographic Details
Published in:Annals of surgical oncology 2013, Vol.20 (1), p.218-225
Main Authors: Asoglu, Oktar, Matlim, Tugba, Kurt, Atilla, Onder, Semen Yesil, Kunduz, Enver, Karanlik, Hasan, Sam, Bulent, Kapran, Yersu, Bugra, Dursun
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis of Variance
Aorta
Autopsy
Body Mass Index
Carcinoma - secondary
Carcinoma - surgery
Chi-Square Distribution
Female
Gastrectomy
Gastrointestinal Oncology
Humans
Lymph Node Excision - standards
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Practice Guidelines as Topic
Prospective Studies
Statistics, Nonparametric
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Surgical Oncology
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Summary:Aims To assess the efficacy of extended lymph node dissection in gastric cancer and to identify factors affecting lymph node detection. Methods A prospective study of 126 gastric cancer patients was conducted. Patients eligible for curative resection received total gastrectomy and extended lymphadenectomy (D2) and paraaortic lymph node sampling as the standard of care (study group). Supramesocolic total lymphadenectomy of the upper gastrointestinal tract was performed on 23 autopsy cases as a control group. Results Fifty-five gastric carcinoma patients were included in the study group. Median age was 58 years (range 31–80 years); 14 patients were female (25 %), and 41 were male (75 %). The median number of lymph nodes harvested from the specimen was 47 (24–95), and the median number of metastatic lymph nodes was 15 (1–71). In contrast, in the autopsy comparative group, the median number of harvested lymph nodes was 72 (50–91). The median number of stational lymph nodes excised (lymph nodes excised from stations 4, 5, 10, 11, 12, and 16) was significantly higher in the control group than in the study group ( P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-012-2544-7