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Vascularizing lymph node dissection for advanced gastric cancer: A single-institution experience

AIM: To compare the short- and long-term outcomes of vascularizing lymph node dissection(VLND) and nonvascularizing lymph node dissection(NVLND) from a single institution.METHODS: Data of 315 patients with advanced gastric cancer who underwent standard D2 lymphadenectomy with curative intent was col...

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Published in:World journal of gastroenterology : WJG 2016-04, Vol.22 (14), p.3813-3820
Main Authors: Han, Fang-Hai, Zhou, Sheng-Ning, Li, Hong-Ming, He, Yu-Long, Zhan, Wen-Hua
Format: Article
Language:English
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Summary:AIM: To compare the short- and long-term outcomes of vascularizing lymph node dissection(VLND) and nonvascularizing lymph node dissection(NVLND) from a single institution.METHODS: Data of 315 patients with advanced gastric cancer who underwent standard D2 lymphadenectomy with curative intent was collected between January 1994 and December 2006. One hundred and fifty-two patients received VLND while 163 patients received NVLND. Short- and long-term clinical outcomes were compared between the two groups. RESULTS: The median followed-up time was 82 mo. The rate of postoperative complications in the VLND group was 13.2%, while that in the NVLND group was 11.7%(P = 0.686). The overall 5-year survival rate was 64% in the VLND group and 59% in the NVLND group(P = 0.047). When subgroup analyses were performed according to Bormann type, type of differentiation and lymph node status, survival benefit was demonstrated in patients with Bormann type Ⅲ or Ⅳ(59% vs 50%, P = 0.032), undifferentiated type(63% vs 49%, P = 0.021) or presence of lymph node metastasis(53% vs 38%, P = 0.010) in the VLND group. CONCLUSION: D2 VLND in advanced gastric cancer treatment allows survival benefit with acceptable morbidity and mortality. VLND for patients with potentially curable advanced gastric cancer is feasible and safe when performed by a well-trained surgical team.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i14.3813