Prognostic importance of radical lymphadenectomy in curative resections for gastric cancer.
OBJECTIVE
To evaluate the effect of extensive lymphadenectomy on survival in patients with gastric cancer.


METHODS
Retrospective analysis


METHODS
University Hospital, Norway.


METHODS
183 patients with stomach cancer resected for cure during the time period 1980-90.


METHODS
78 patients had an R1- and 105 patients and R2 resection. 124 patients were treated by total gastrectomy, 5 by proximal--and 54 by distal resection.


METHODS
Morbidity, mortality and long term survival.


RESULTS
The morbidity was 33% (60/183), of which 39 (21%) were general complications (pneumonia, thrombosis, or cardiovascular disease). 14 patients died postoperatively (8%). By logistic regression analysis we found that splenectomy was the only variable associated with both morbidity and immediate postoperative mortality. Five year survival was 39% for patients who had undergone curative resections, 30% for patients who had had an R1 resection, and 47% for those who had had an R2 resection. By multivariate analysis (Cox) we found that N-classification (TNM), tumour diameter of less than 45 mm, type of lymph node dissection (R2) and operation period (after 1984) correlated with improved survival.


CONCLUSIONS
Extensive lymph node dissection improves survival without increasing morbidity or postoperative mortality.
Viste
A
A
Department of Surgery, University of Bergen, Norway.
Svanes
K
K
Janssen
C W
CW
Maartmann-Moe
H
H
Søreide
O
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors