Results of D2 gastrectomy for gastric adenocarcinoma: 10-year experience in Thai patients.
BACKGROUND
The therapeutic value of D2 gastrectomy in the curative treatment of gastric adenocarcinoma is controversial outside Japan.


METHODS
The authors retrospectively reviewed the medical records of 97 patients with gastric adenocarcinoma who underwent curative D2 gastrectomy between October 1995 and September 2005.


RESULTS
Subtotal gastrectomy was performed in 42/97 patients (43%) and total gastrectomy in 55/97 patients (57%), with an average number of 38 lymph nodes (range, 22-82) and 48 lymph nodes (range, 24-126) removed, respectively. Overall morbidity rate was 17% (16/97). There was no hospital mortality. The 5-year overall and 5-year disease-free survival rates were 59% and 46%, respectively. The 5-year disease-free survival rate for each TNM stage was 100% for stages IA and IB, 75% for stage II, 78% for stage IIIA, 28% for stage IIIB and 4% for stage IV. Of the 43/97 patients (44%) who had metastasis to the level 2 (N2) lymph nodes, 14/ 43 patients (33%) survived more than 5 years.


CONCLUSIONS
The D2 gastrectomy can be performed with low morbidity and mortality, and may increase the cure rate and survival of Thai gastric adenocarcinoma patients, at least in experienced centers.
Euanorasetr
Chakrapan
C
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. racen@mahidol.ac.th
Lertsithichai
Panuwat
P
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D013534:Survival; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome