Extended lymphadenectomy is associated with a survival benefit for node-negative gastric cancer Journal Article
| Authors: | Harrison, L. E.; Karpeh, M. S.; Brennan, M. F. |
| Article Title: | Extended lymphadenectomy is associated with a survival benefit for node-negative gastric cancer |
| Abstract: | The purpose of this study was to determine whether extended lymph node (D2) dissection is associated with a survival benefit for patients with histologically node-negative gastric cancer at a single institution in the United States. Review of the prospective gastric database at Memorial Sloan-Kettering Cancer Center from July 1985 to August 1995 identified 774 patients who had undergone curative gastric resection. Of these, 247 patients (32%) were identified with histologically negative lymph nodes by hematoxylin-eosin staining. Data are expressed as median (range). Overall survival was compared by log-rank test. The overall 5-year survival rate for the entire cohort was 79%. The extent of lymph node dissection did not predict survival over the entire cohort. However, when stratified for tumor (T) stage, D2 dissection offered a survival advantage for T3 tumors. The 5-year survival rate for patients with T3 tumors undergoing a D2 dissection (n = 15) was 54% compared to 39% for those undergoing a D1 dissection (n = 53, P <0.05). D2 dissection is associated with improved survival in advanced T stage, node-negative gastric cancer. With adequate staging, results of gastric resection for adenocarcinoma in Western countries begin to approximate those seen in Japan. Excision of N2 lymph nodes may also remove microscopic metastatic disease, contributing to the survival benefit. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; comparative study; cancer staging; follow up; methodology; follow-up studies; lymph node metastasis; lymph nodes; lymphatic metastasis; neoplasm staging; prospective study; lymph node excision; prospective studies; lymphadenectomy; adenocarcinoma; linear models; metastasis; cohort studies; proportional hazards models; cohort analysis; pathology; data base; retrospective study; proportional hazards model; lymph node; gastrectomy; multivariate analysis; analysis of variance; statistical model; stomach neoplasms; stomach tumor; databases; humans; human; male; female; article |
| Journal Title: | Journal of Gastrointestinal Surgery |
| Volume: | 2 |
| Issue: | 2 |
| ISSN: | 1091-255X |
| Publisher: | Springer |
| Date Published: | 1998-04-01 |
| Start Page: | 126 |
| End Page: | 131 |
| Language: | English |
| PUBMED: | 9834407 |
| PROVIDER: | scopus |
| DOI: | 10.1016/S1091-255X(98)80002-4 |
| DOI/URL: | |
| Notes: | Article -- Presented at 38th Annual Meeting of The Society for Surgery of the Alimentary Tract which took place May 11–14, 1997 in Washington, D.C. -- Export Date: 12 December 2016 -- Source: Scopus |
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