[Lymph node dissection around the splenic artery for gastric cancer--a comparative study of pancreatectomy and pancreas-preserving operation].
From 1977 to 1988, four hundred and sixty-five patients received total or proximal gastrectomy for advanced gastric cancer without leaving a tumor mass at National Cancer Center Hospital. Of these, 182 patients received distal pancreatectomy (PS) and 123 received pancreas-preserving operation with removal of the splenic artery (PP). The 5-year survival rate for the PS group (32.0%) was significantly lower than 61.0% for the PP group. Concerning grades of cancer stage, the 5-year survival rates for the PP group were better than those for the PS group in stages 1, 2 and 3. Seventy-four of the 465 patients were found to have histologically proven metastatic nodes around the splenic artery. Their 5-year survival rates were 9.2% for the PS group (n = 46) and 32.7% for the PP group (n = 13) respectively. Considering the difference in the background factors, these data suggest the effectiveness of the pancreas-preserving operation for advanced gastric cancer even with microscopic lymph node metastasis around the splenic artery. The pancreas-preserving operation with removal of the splenic artery might be indicated for the patient without definite macroscopically metastatic lymph node around the splenic artery.
Kinoshita
T
T
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Maruyama
K
K
Sasako
M
M
Okabayashi
K
K
D005743:Gastrectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality; D013157:Splenic Artery / Q000601:surgery*; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate