EFFECT OF EXTENSIVE LYMPH NODE DISSECTION ON THESURVIVAL OF PN0 AND PN1 GASTRIC CANCER
ERHAN REİS, NURİ A KAMA, MUTLU DOĞANAY, MURAT KOLOĞLU, MESUT ATLI, METE DOLAPÇI
Ankara Numune Eğitim ve Araştırma Hastanesi, 4. Cerrahi Kliniği, ANKARA
The therapeutic value of extended lymph node dissection (D2) for gastric cancer remains controversial. The purpose of this study was to determine whether extended lymph node (D2) dissections associated with a survival benefit for patients with histological pN0 and pN1 gastric cancer. Review of the prospective gastric cancer database at single institution of Ankara Numune Educational and Research Hospital from January 1992 to April 1999 were carried out. Totally 118 patients underwent potentially curative gastric resection, of these 91(77.1%) patients were identified to be histologically pN0 or pN1 according to hematoxylen-eosin staining. The ages of the patients ranged between 41 82(mean 61,8) years and 64(70.3%) patients were male. Mean follow-up period was 41 months for survived patients, 52 (57,1%) patients underwent limited lymph node(Dl) dissection and 39 (42,9%)patients underwent extended lymph node (D2) dissection. The morbidity was 27.5 percent and 9 (9.9%)patients died postoperatively, Five years survival was 33.3% for all patients, 22.5 % for who had D1 lymphadenectomy and 50.5%for who had D2 lymphadenectomy (p=0.0137)(compared by long-rank test), There was not any difference in postoperative morbidity (32.7% vs 20,5%) and mortality (10.3% vs9.6%) between two groups. Also there was not any difference between two groups according to chi-square test for prognostic factors.This study results show that extensive lymph node (D2) dissection improves the survival in pN0 and pN1 gastric cancer without increasing postoperative morbidity and mortality.
Keywords: GASTRIC CANCER, LYMPH NODE DISSECTION, LONG -TERM SURVIVAL