Wert der systematischen erweiterten Lymphknotendissektion--Ergebnisse in Japan. [Value of systematic extended lymph node dissection--results in Japan].

In the National Cancer Center, 6112 patients with primary gastric cancer have undergone gastric resection since 1962, and the 5-year survival rate (5YSR) was 57.5%. In the 25-year period, 5YSR rose from 57% to 83% in stage II disease, and from 33% to 50% in stage III disease. Systematic lymph node dissection (R2 dissection) played major role in this improvement. It gave significantly better prognosis (5YSR, 48%) than incomplete dissection (31%), particularly reducing local recurrence. The proportion of local recurrence was 38% in 1967-1971, however it decreased to 16% in 1982-1986 by introduction of this treatment. Disadvantages of the dissection were minimal. Surgical death rate was 3.0% in the 1960s but it was only 0.6% in the 1980s.