AIM: To analyze the prognostic impact of lymphade-nectomy extent in advanced gastric cancer located in the cardia and fundus. METHODS: Two hundred and thirty-six patients with advanced gastric cancer located in the cardia and fundus who underwent D2 curative resection were analyzed retrospectively. Relationships between the numbers of lymph nodes (LNs) dissected and survival was analyzed among different clinical stage subgroups. RESULTS: The 5-year overall survival rate of the entire cohort was 37.5%. Multivariate prognostic variables were total LNs dissected (P < 0.0001; or number of negative LNs examined, P < 0.0001), number of positive LNs (P < 0.0001), T category (P < 0.0001) and tumor size (P = 0.015). The greatest survival differences were observed at cutoff values of 20 LNs resected for stage II (P = 0.0136), 25 for stage III(P < 0.0001), 30 for stage IV (P = 0.0002), and 15 for all patients (P = 0.0024). Based on the statistically assumed linearity as best fit, linear regression showed a significant survival enhancement based on increasing negative LNs for patients of stages III (P = 0.013) and IV (P = 0.035). CONCLUSION: To improve the long-term survival of patients with advanced gastric cancer located in the cardia and fundus, removing at least 20 LNs for stage II, 25 LNs for stage III, and 30 LNs for stage IV patients during D2 radical dissection is recommended.
AIM: To analyze the prognostic impact of lymphade-nectomy extent in advanced gastric cancer located in the cardia and fundus. METHODS: Two hundred and thirty-six patients with advanced gastric cancer located in the cardia and fundus who underwent D2 curative resection were analyzed retrospectively. Relationships between the numbers of lymph nodes (LNs) dissected and survival was analyzed among different clinical stage subgroups. RESULTS: The 5-year overall survival rate of the entire cohort was 37.5%. Multivariate prognostic variables were total LNs dissected (P < 0.0001; or number of negative LNs examined, P < 0.0001), number of positive LNs (P < 0.0001), T category (P < 0.0001) and tumor size (P = 0.015). The greatest survival differences were observed at cutoff values of 20 LNs resected for stage II (P = 0.0136), 25 for stage III(P < 0.0001), 30 for stage IV (P = 0.0002), and 15 for all patients (P = 0.0024). Based on the statistically assumed linearity as best fit, linear regression showed a significant survival enhancement based on increasing negative LNs for patients of stages III (P = 0.013) and IV (P = 0.035). CONCLUSION: To improve the long-term survival of patients with advanced gastric cancer located in the cardia and fundus, removing at least 20 LNs for stage II, 25 LNs for stage III, and 30 LNs for stage IV patients during D2 radical dissection is recommended.
Authors: Giovanni de Manzoni; Paolo Morgagni; Franco Roviello; Alberto Di Leo; Luca Saragoni; Daniele Marrelli; Alfredo Guglielmi; Alfonso Carli; Secondo Folli; Claudio Cordiano Journal: Gastric Cancer Date: 1998-03 Impact factor: 7.370
Authors: Dong Yi Kim; Jae Kyoon Joo; Seong Yeob Ryu; Young Kyu Park; Young Jin Kim; Shin Kon Kim Journal: Dig Surg Date: 2006-12-11 Impact factor: 2.588
Authors: Dong Yi Kim; Kyeung Won Seo; Jae Kyoon Joo; Young Kyu Park; Seong Yeob Ryu; Hyeong Rok Kim; Young Jin Kim; Shin Kon Kim Journal: World J Gastroenterol Date: 2006-02-28 Impact factor: 5.742
Authors: José M del Casar; María D Corte; Ana Alvarez; Isabel García; Miguel Bongera; Luis O González; José L García-Muñiz; María T Allende; Aurora Astudillo; Francisco J Vizoso Journal: J Cancer Res Clin Oncol Date: 2007-07-13 Impact factor: 4.553