[Lymphadenectomy in gastric carcinoma?].
Lymphadenectomy in gastric carcinoma is still discussed. Based on non-randomised and randomised studies D2-lymphadenectomy is indicated only in R0-resections. D2-lymph-node dissection requires great experience with this technique as well as for the management of possible postoperative complications. Survival advantages can be expected in patients with a limited nodal involvement, a favorable lymph node ratio between resected and involved nodes and in stage II disease. Therefore, survival improvement can be expected in 15-20 % of all R0-resections. Despite these limited prognostic advantages D2-lymphadenectomy should be performed in all R0-procedures since only the pathologic data of the resected specimen supply reliable prognostic parameter. If in the future sentinel lymphadenectomy allows selection criteria for a balanced indication for D2-lymphadenectomy in gastric carcinoma, needs to be awaited.
Jähne
J
J
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Zentrum Chirurgie, Henriettenstiftung Hannover, Germany. avg.chirurgie@henriettenstiftung.de
D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate