Prophylactic lymph node dissection in patients with advanced gastric cancer promotes increased survival time.
BACKGROUND
There is no consensus of opinion regarding the efficacy of lymph node dissection.


METHODS
Data were analyzed from 452 patients with advanced gastric cancer who underwent curative resection in the Department of Surgery II, Kyushu University Hospital, between 1970 and 1985, with special reference to the lymph node metastasis.


RESULTS
Metastatic lesions were evident in the dissected lymph nodes of 300 of 452 (66.4%) patients. Survival time for patients without lymph node metastasis was longer than for those with it (P less than 0.01). In patients without lymph node metastasis, the tumor was smaller, serosal invasion was less prominent, tumor growth was less infiltrating, and the tumor stage was, therefore, less advanced. Lymphatic involvement was found in 38.9% of the patients with no evidence of lymph node metastasis.


CONCLUSIONS
Because the postoperative mortality rate is low in patients with lymph node dissection, the authors advocate prophylactic lymph node dissection to prevent a recurrence.
Maehara
Y
Y
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Okuyama
T
T
Moriguchi
S
S
Orita
H
H
Kusumoto
H
H
Korenaga
D
D
Sugimachi
K
K
D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate