Comparison of surgical results of D2 versus D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric carcinoma: a multi-institutional study

Annals of Surgical Oncology
C KunisakiH Shimada

Abstract

Curative gastrectomy is a promising approach for the treatment of gastric cancer; however, the optimal extent of lymph node dissection for advanced cancer remains controversial. The aim of this multi-institutional study was to evaluate the feasibility of D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric cancer. The surgical results of D2 and D3 gastrectomy (para-aortic lymph node dissection) were retrospectively compared. A series of 580 advanced gastric cancer patients were registered between 1992 and 2000. Of these, 430 underwent D2 gastrectomy and 150 underwent D3 gastrectomy. Survival time, prognostic factors, postoperative morbidity/mortality, and pattern of recurrence were compared. There was no significant difference in survival time between D2 and D3 patients. However, the survival times of D3 patients with tumor diameters measuring 50 to 100 mm or with pN1 disease were significantly longer than those of the corresponding D2 patients. Analysis of the survival of patients with tumor diameters measuring 50 to 100 mm revealed that D3 gastrectomy conferred a survival advantage only to patients with pN2 disease. The incidence of lymphatic recurrence was lower in D3 patients with 50- to 100-mm tumors tha...Continue Reading

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Citations

May 16, 2014·Journal of Cancer Research and Clinical Oncology·Yan MaShu-Peng Zhao
Mar 6, 2010·World Journal of Gastroenterology : WJG·Zhen WangYun-Fei Cao
Jun 2, 2012·World Journal of Gastroenterology : WJG·Jadwiga SnarskaAnna Żurada
Feb 26, 2009·Annals of Surgical Oncology·Suk Hee ShinSung Kim
Feb 16, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S MoritaH Katai
Jul 29, 2016·Oncoimmunology·Lucia CottoneAngelo A Manfredi
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May 31, 2018·Updates in Surgery·Valentina MengardoGiovanni de Manzoni
May 22, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Chikara KunisakiHiroshi Shimada
Sep 14, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Chikara KunisakiHiroshi Shimada
Oct 9, 2007·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Masanori TokunagaToshiharu Yamaguchi
Feb 3, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Chen LiSung Hoon Noh
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