Extensive versus limited lymph node dissection for gastric cancer: A comparative study of 320 patients

Publisher Website
Google Scholar
Abstract
To compare extensive with limited lymph node dissection in the surgical treatment of gastric cancer, 320 patients undergoing gastric resection during 1981–1990 were divided into two groups. Although patients undergoing extended lymphadenectomy (n = 157) had a longer operating time (P = 0·0001) and a greater intraoperative blood transfusion requirement (P = 0·009) than those receiving limited dissection (n = 163), the incidence of postoperative complications (22·3 versus 28·2 per cent, P = 0·13) and the hospital mortality rate (3·8 versus 7·4 per cent, P = 0·12) were similar in the two groups. The 5-year survival rate after curative resection (117 and 121 patients after extensive and limited lymph node dissection respectively) was 65·4 versus 50·1 per cent (P = 0·01): 85·9 versus 82·2 per cent for stage I disease (P = 0·60), 66·1 versus 57·8 per cent for stage II (P = 0·82) and 48·7 versus 29·8 per cent for stage III (P = 0·02). Multivariate analysis using the Cox model showed that the extent of lymphadenectomy was an independent prognostic factor for survival (P = 0·01). The results support the value of extensive lymph node dissection in the surgical treatment of gastric carcinoma.