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D2 plus para-aortic lymphadenectomy versus standardized D2 lymphadenectomy in gastric cancer surgery.
- Source :
-
Surgery Today . Mar2009, Vol. 39 Issue 3, p207-213. 7p. - Publication Year :
- 2009
-
Abstract
- Abstract Purpose  To evaluate the survival benefits and safety of D2 plus para-aortic lymphadenectomy (D2 + PALD) for gastric carcinoma. Methods  Patients with gastric carcinoma, who agreed to undergo D2 + PALD between February 2001 and December 2003, were allocated to the D2 + PALD group, and compared with a control group who underwent D2 lymphadenectomy. Patients were followed up until August 2007. Results  Sixty-two patients were allocated to the D2 + PALD group, and a concurrent 55 patients were allocated to the D2 group. The mean follow-up period was 57.6 (range 43.0—77.6) months, with 11.1% lost to follow-up. The morbidity and mortality rates were 24.2% and 0% in the D2 + PALD group, and 27.3% and 1.8% in the D2 group, respectively. The overall 3- and 5-year survival rates were 77.5% and 65.8% in the D2 + PALD group, and 73.2% and 66.1% in the D2 group, respectively, without a significant difference. The frequency of metastasis to the para-aortic lymph nodes (PALN) was 8.1%. The logistic regression revealed that PALN metastasis was correlated to metastasis of No. 8a and No. 9 lymph nodes (P = 0.021 and P = 0.030, respectively). Conclusion  Although D2 + PALD can be performed safely with an acceptable incidence of complications when performed by well-trained gastrointestinal surgeons, its survival benefits are not significantly greater than those of D2 lymphadenectomy. Therefore, routine D2 + PALD should not be recommended. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09411291
- Volume :
- 39
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Surgery Today
- Publication Type :
- Academic Journal
- Accession number :
- 36893389
- Full Text :
- https://doi.org/10.1007/s00595-008-3856-x