Extended lymph node dissection in gastrointestinal cancer.
We reviewed the literature concerning the effect of extended lymph node dissection on survival in patients with gastrointestinal cancer. Most retrospective and/or prospective nonrandomized comparative studies have claimed that extended lymph node dissection significantly improves survival rate in patients with esophageal cancer, gastric cancer, and colorectal cancer. However, it is difficult to interpret these results since specialized care provided in trials may itself improve survival. In gastric cancer, several prospective randomized trials have failed to demonstrate a survival advantage of extended dissection, while there are few well-done prospective randomized trials in esophageal or colorectal cancer. Therefore, the therapeutic value of extended lymph node dissection remains to be determined in gastrointestinal cancer. Randomized prospective studies within the bounds of the ethical treatment of patients can and should be done.
Noguchi
M
M
Operation Center, Kanazawa University Hospital, School of Medicine, Kanazawa University, Japan.
Miyazaki
I
I
D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods / Q000401:mortality*; D016032:Randomized Controlled Trials as Topic; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery; D015996:Survival Rate