Therapeutic value of lymph node dissection and the clinical outcome for patients with gastric cancer.
BACKGROUND
While the incidence of gastric cancer differs greatly between Japan and other countries, both diagnostic and treatment modalities for patients with gastric cancer have improved in Japan. What follows is an overview of the effects of lymph node dissection for such patients.


METHODS
We analyzed data on 2152 Japanese men and women with gastric cancer who underwent surgical resection from 1965 to 1995 at Kyushu University in Fukuoka, Japan. We focused on time trends of surgical management, including lymph node dissection and postoperative outcome.


RESULTS
In all cases of gastric cancer, the rate of early gastric cancer increased from 18% in the first 6-year period to 57% in the last 5-year period. Extensive lymph node dissections (D2 and D3) were performed more frequently in recent years. Due to early identification of the cancer and upgraded perioperative care, both postoperative morbidity and mortality rates 30 days after surgery have decreased greatly, even in aged patients.


CONCLUSIONS
Early tumor detection, standardized surgical treatment, including routine lymph node dissection, and improved perioperative management have led to increased survival time among patients with this malignancy.
Maehara
Yoshihiko
Y
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kakeji
Yoshihiro
Y
Koga
Tadashi
T
Emi
Yasunori
Y
Baba
Hideo
H
Akazawa
Kohei
K
Sugimachi
Keizo
K
D006801:Humans; D008197:Lymph Node Excision; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome