Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases

A retrospective immunohistological analysis of 100 patients with pT1–3 N0 and pT1–3 N1 gastric adenocarcinoma demonstrated a high frequency of micro‐involvement in the removed lymph nodes. The presence of three or more tumour cells in more than 10 per cent of the lymph nodes was of significant progn...

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Bibliographic Details
Published in:British journal of surgery 1996-08, Vol.83 (8), p.1144-1147
Main Authors: Siewert, J. R., Kestlmeier, R., Busch, R., Böttcher, K., Roder, J. D., Müller, J., Fellbaum, C., Höfler, H.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Neoplasm Staging
Retrospective Studies
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Survival Rate
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Summary:A retrospective immunohistological analysis of 100 patients with pT1–3 N0 and pT1–3 N1 gastric adenocarcinoma demonstrated a high frequency of micro‐involvement in the removed lymph nodes. The presence of three or more tumour cells in more than 10 per cent of the lymph nodes was of significant prognostic value in the pN0 cases. Multivariate analysis identified micro‐involvement as an independent prognostic factor. The results explain why patients benefit from lymphadenectomy even if the removed lymph nodes are not involved by tumour (pN0) in routine histological examination. The frequent occurrence of micro‐involvement is a strong argument favouring routine D2 lymph node dissection in gastric cancer surgery in patients with lymph node metastasis.
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.1800830836