BACKGROUND: Short-term results of gastric cancer surgery vary remarkably worldwide, and international surgical quality criteria are urgently needed. To contribute to defining these criteria, we reviewed short-term results of gastrectomy for gastric cancer in three centers of the Italian Research Group for Gastric Cancer, with an average of 24.7, 29.5, and 18 gastrectomies per year. METHODS: Between 1988 and 2002, 1,032 patients underwent gastrectomy for gastric cancer in Verona, Siena, and Padua. D1, D2, and D3 lymphadenectomy were performed, respectively, in 228, 584, and 220 cases. RESULTS: The median number of retrieved lymph nodes was 14 (interquartile range 9-18.75) after D1, 29 (21-38) after D2, and 46.5 (37-57) after D3. Fewer than 15 nodes were retrieved in 54.5%, 6.2%, and 1.4% of cases undergoing, respectively, D1, D2, and D3. Adjacent organ removal was rare during D1 (splenectomy: 6.1%, splenopancreasectomy: 1.8%), and quite common during D3 (11.4%, 11.4%). Forty patients (3.9%) died postoperatively. Neither postoperative morbidity nor mortality was significantly associated with extension of lymphadenectomy. CONCLUSION: We conclude that at least D2 lymphadenectomy is necessary to achieve adequate disease staging (>or=15 nodes retrieved). Spleen and pancreas tail are more frequently removed during D3, but this removal is not associated with higher postoperative morbidity or mortality.
BACKGROUND: Short-term results of gastric cancer surgery vary remarkably worldwide, and international surgical quality criteria are urgently needed. To contribute to defining these criteria, we reviewed short-term results of gastrectomy for gastric cancer in three centers of the Italian Research Group for Gastric Cancer, with an average of 24.7, 29.5, and 18 gastrectomies per year. METHODS: Between 1988 and 2002, 1,032 patients underwent gastrectomy for gastric cancer in Verona, Siena, and Padua. D1, D2, and D3 lymphadenectomy were performed, respectively, in 228, 584, and 220 cases. RESULTS: The median number of retrieved lymph nodes was 14 (interquartile range 9-18.75) after D1, 29 (21-38) after D2, and 46.5 (37-57) after D3. Fewer than 15 nodes were retrieved in 54.5%, 6.2%, and 1.4% of cases undergoing, respectively, D1, D2, and D3. Adjacent organ removal was rare during D1 (splenectomy: 6.1%, splenopancreasectomy: 1.8%), and quite common during D3 (11.4%, 11.4%). Forty patients (3.9%) died postoperatively. Neither postoperative morbidity nor mortality was significantly associated with extension of lymphadenectomy. CONCLUSION: We conclude that at least D2 lymphadenectomy is necessary to achieve adequate disease staging (>or=15 nodes retrieved). Spleen and pancreas tail are more frequently removed during D3, but this removal is not associated with higher postoperative morbidity or mortality.
Authors: Daniele Marrelli; Karol Polom; Giovanni de Manzoni; Paolo Morgagni; Gian Luca Baiocchi; Franco Roviello Journal: World J Gastroenterol Date: 2015-07-14 Impact factor: 5.742
Authors: Marco Catarci; Leonardo Antonio Montemurro; Sabrina Ghinassi; Antonio Di Cintio; Leonardo Leone; Luigi Marino Cosentino; Maria Antonietta Viarengo; Giovanni Battista Grassi Journal: Updates Surg Date: 2011-03-29
Authors: Giuseppe Verlato; Simone Giacopuzzi; Maria Bencivenga; Paolo Morgagni; Giovanni De Manzoni Journal: World J Gastroenterol Date: 2014-09-28 Impact factor: 5.742
Authors: Giuseppe Verlato; Daniele Marrelli; Simone Accordini; Maria Bencivenga; Alberto Di Leo; Alberto Marchet; Roberto Petrioli; Giacomo Zoppini; Michele Muggeo; Franco Roviello; Giovanni de Manzoni Journal: World J Gastroenterol Date: 2015-06-07 Impact factor: 5.742
Authors: Maurizio Degiuli; Giovanni De Manzoni; Alberto Di Leo; Domenico D'Ugo; Erica Galasso; Daniele Marrelli; Roberto Petrioli; Karol Polom; Franco Roviello; Francesco Santullo; Mario Morino Journal: World J Gastroenterol Date: 2016-03-14 Impact factor: 5.742