title: Is extended lymphadenectomy valuable in palliatively gastrectomized patients with gastric cancer and simultaneous peritoneal metastasis?
abstract: OBJECTIVE
  The optimal extent of lymphadenectomy in patients with gastric cancer and simultaneous peritoneal metastasis upon non-curative resection remains unclear. The aim of the present study was to evaluate the efficacy of extended lymphadenectomy in palliatively gastrectomized patients with gastric cancer and simultaneous peritoneal metastasis.
  
  
  METHODS
  The significance and limit of extended lymphadenectomy according to the extent of peritoneal metastasis was analyzed retrospectively in 110 patients with gastric cancer and simultaneous peritoneal metastasis who had undergone palliative gastrectomy.
  
  
  RESULTS
  Of the 47 patients with P1 metastasis, the median survival period of the 23 patients who underwent extended lymphadenectomy and the 24 patients who underwent limited lymphadenectomy was 21.7 months and 17.2 months, respectively. Of the 63 patients with P2 or P3 metastasis, the median survival period of the 16 patients who underwent extended lymphadenectomy and the 47 patients who underwent limited lymphadenectomy was 10.4 months and 12.8 months, respectively. No significant differences in survival time based on extent of lymphadenectomy were observed either in the patients with P2 or P3 metastasis (P = 0.262) or in those with P1 metastasis (P = 0.277).
  
  
  CONCLUSIONS
  The results of the present study demonstrate that extended lymphadenectomy in gastric cancer yields no positive impact on survival upon non-curative resection either in patients with gastric cancer and simultaneous metastases to the adjacent peritoneum (P1) or to the distant peritoneum (P2 or P3).
authors.affiliation: Department of Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Tsukamoto
authors.forename: H
authors.initials: H
authors.lastname: Shimao
authors.forename: Y
authors.initials: Y
authors.lastname: Sakakibara
authors.forename: Y
authors.initials: Y
authors.lastname: Hiki
authors.forename: A
authors.initials: A
authors.lastname: Kakita
mesh_terms: D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome