An evaluation of the effectiveness of extended lymph node dissection in patients with gastric cancer: a retrospective study of 1403 cases at a single institution

The Journal of Surgical Research
Yuichi KasakuraTadatoshi Takayama

Abstract

Many investigators have reported that extended lymph node dissection (D2 dissection) is probably an effective procedure. However, the theory that D2 dissection leads to an improvement in survival has not been confirmed in randomized trials. We attempted to confirm the effectiveness of D2 dissection with gastrectomy for gastric cancer. Gastric cancer patients (1403) underwent curative resection by D1 (991 patients) or D2 (412 patients) dissection with gastrectomy. Survival rates calculated for all patients and subdivided for stage, depth of invasion, and lymph node metastasis were compared between the two groups. The diagnosis of lymph node metastasis was compared between macroscopic and histological findings. There was no significant difference in the survival of patients overall. However, in the patients with stage II, T1 or T2, or N1 disease, the survival of the D2 group was significantly better than that of the D1 group. The false positive rates of lymph node metastasis were 53.3% in the N1 group, 26.2% in the N2 group, and 9.2% in the N3 group. In a considerable proportion of the N1 and N2 patients, histological findings proved more or fewer metastases than macroscopic diagnosis. Metastatic lymph nodes should be resected as...Continue Reading

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Citations

Aug 4, 2011·Gastroenterology Research and Practice·Chang-Ming HuangJia-Bin Wang
Aug 25, 2009·World Journal of Gastroenterology : WJG·Chang-Ming HuangHui-Shan Lu
Apr 8, 2014·World Journal of Gastroenterology : WJG·Xu-Guang JiaoHan Liang
May 22, 2013·World Journal of Surgical Oncology·Luigina GraziosiAnnibale Donini
Jun 3, 2009·World Journal of Surgery·Shinji IshikawaHideo Baba
Jul 26, 2005·Langenbeck's Archives of Surgery·Takashi IchikuraHidetaka Mochizuki
Mar 5, 2011·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·C-M HuangB-J Lin
Oct 23, 2004·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·G FotiaF Roviello
Jul 30, 2005·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·D NittiM Lise
Aug 30, 2008·American Journal of Surgery·Sun Hu YangNeel Sharma
Jan 28, 2015·Lung India : Official Organ of Indian Chest Society·Reza BagheriAta'ollah Rajabnejad
Oct 1, 2016·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Deme SwaroopaVijay Kumar Kutala
Apr 28, 2007·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·H DanielsonP Puolakkainen

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