Body mass index does not affect systematic D2 lymph node dissection and postoperative morbidity in gastric cancer patients

The extent of standard lymph node dissection (D1, D2, or D3) in gastric cancer patients is still controversial. Several prospective European trials attained contradictory results. A generally increased body mass index (BMI) of the European patients was assumed to be one of the major causes for posto...

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Bibliographic Details
Published in:Annals of surgical oncology 2003-05, Vol.10 (4), p.363-368
Main Authors: Gretschel, Stephan, Christoph, Frank, Bembenek, Andreas, Estevez-Schwarz, Lope, Schneider, Ulrike, Schlag, Peter M
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Blood Loss, Surgical
Body Mass Index
Female
Gastrectomy
Humans
Lymph Node Excision
Male
Middle Aged
Morbidity
Neoplasm Staging
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:The extent of standard lymph node dissection (D1, D2, or D3) in gastric cancer patients is still controversial. Several prospective European trials attained contradictory results. A generally increased body mass index (BMI) of the European patients was assumed to be one of the major causes for postoperative morbidity. We evaluated the effect of BMI on the quality of routine D2 lymph node dissection and on postoperative morbidity in patients with gastric cancer who underwent a potentially curative total gastrectomy. A total of 199 consecutive gastric cancer patients who underwent a total gastrectomy and a routine D2 lymph node dissection between 1992 and 2001 were included in the study. According to BMI, they were assigned to three groups: group A, with BMI 30 kg/m(2) (obesity). Parameters such as complete histopathological staging, intraoperative blood loss, length of operation, and surgical and nonsurgical morbidity were recorded and correlated within the different groups. No significant differences were found with regard to the number of examined lymph nodes, blood loss, length of operation, surgical complications, or length of stay in the intensive care unit. In contrast to comparable Japanese studies, our analysis reveals that even for overweight patients, a standard D2 lymph node dissection is justified without significantly increased morbidity.
ISSN:1068-9265
1534-4681
DOI:10.1245/ASO.2003.07.011