BACKGROUND: Our objective was to evaluate the long-term benefit of R2/3 lymph node dissection compared with that of R1, even in node-negative cases. METHODS: We analyzed clinicopathologic data on 373 surgically treated patients with early gastric cancer and without microscopic nodal involvement. RESULTS: Five- and 10-year survival rates for patients treated with R2/3 gastrectomy were 97.3% and 95.4%, respectively. These values were significantly higher than the 90.1% and 81.1% noted for R1 gastrectomy (p < 0.01). Although no difference was found in morbidity and mortality, the incidence of death from a recurrence of the gastric cancer was significantly higher in patients treated with R1 gastrectomy than those with R2/3. Multivariate analysis with the Cox's proportional hazard model revealed patients' age and R2/3 gastrectomy to be independent prognostic factors in patients with node-negative early gastric cancer. CONCLUSIONS: These data show that prophylactic lymph node dissection can potentially prolong the survival time of patients with node-negative early gastric cancer by preventing a recurrence of the gastric cancer.
BACKGROUND: Our objective was to evaluate the long-term benefit of R2/3 lymph node dissection compared with that of R1, even in node-negative cases. METHODS: We analyzed clinicopathologic data on 373 surgically treated patients with early gastric cancer and without microscopic nodal involvement. RESULTS: Five- and 10-year survival rates for patients treated with R2/3 gastrectomy were 97.3% and 95.4%, respectively. These values were significantly higher than the 90.1% and 81.1% noted for R1 gastrectomy (p < 0.01). Although no difference was found in morbidity and mortality, the incidence of death from a recurrence of the gastric cancer was significantly higher in patients treated with R1 gastrectomy than those with R2/3. Multivariate analysis with the Cox's proportional hazard model revealed patients' age and R2/3 gastrectomy to be independent prognostic factors in patients with node-negative early gastric cancer. CONCLUSIONS: These data show that prophylactic lymph node dissection can potentially prolong the survival time of patients with node-negative early gastric cancer by preventing a recurrence of the gastric cancer.
Authors: Bryan J Dicken; David L Bigam; Carol Cass; John R Mackey; Anil A Joy; Stewart M Hamilton Journal: Ann Surg Date: 2005-01 Impact factor: 12.969
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