Outcome of prophylactic radical lymphadenectomy with gastrectomy in patients with early gastric carcinoma without lymph node metastasis.
BACKGROUND
Prophylactic extended lymphadenectomy with gastrectomy may prolong survival in patients with early gastric carcinoma without lymph node metastasis. However, the therapeutic value of extensive lymphadenectomy in patients with early gastric carcinoma remains controversial.


METHODS
The authors retrospectively analyzed 423 patients with early gastric carcinoma without lymph node metastasis who underwent gastrectomy and did not die of other diseases to evaluate the effect of prophylactic extended lymphadenectomy on postoperative survival. The postoperative survival rate of patients who underwent prophylactic extended lymphadenectomy was compared with that of patients who underwent prophylactic limited lymphadenectomy.


RESULTS
Although extended lymphadenectomy did not appear to improve the postoperative survival rate of patients with mucosal tumors, it did improve the postoperative survival rate of patients with submucosal tumors. Whether prophylactic extended lymphadenectomy was performed significantly affected outcome in patients with early gastric carcinoma who had submucosal tumors without regional lymph node metastasis.


CONCLUSIONS
Extensive lymphadenectomy with gastrectomy should be performed to prolong the survival of the patients with submucosal tumors.
Otsuji
E
E
Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto Japan. otsuji@1surg.kpu-m.ac.jp
Toma
A
A
Kobayashi
S
S
Okamoto
K
K
Hagiwara
A
A
Yamagishi
H
H
D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome