title: Rationale for gastrectomy with D2 lymphadenectomy in the treatment of gastric cancer.
abstract: BACKGROUND
  In the surgical management of gastric cancer, D2 lymphadenectomy aims to reduce the incidence of locoregional relapse, and to increase patient survival.
  
  
  METHODS
  A prospective study was made of 126 consecutive patients operated upon for gastric cancer, with gastrectomy and D2 lymphadenectomy. Hospital morbidity and mortality, relapses, and patient survival after 5 years were studied.
  
  
  RESULTS
  The overall hospital mortality rate was 1.6%, with a mortality of 2.1% in the patients submitted to total gastrectomy. The overall morbidity rate was 29.4%. Dehiscence of the esophagojejunal anastomosis was recorded in 1.6%. The median follow-up was 73.6 months. Relapses were observed in 37% of the patients (76% in the first 2 years). Overall actuarial survival after 5 years was 52.3%, and 5-year survival in the patients with R0 resection with positive N2 lymph nodes according to the Japanese classification was 26.5%.
  
  
  CONCLUSIONS
  Our results show that D2 lymphadenectomy can be performed with low morbidity-mortality, and a 5-year survival of more than 50%. The procedure offers benefit in terms of survival for a certain percentage of patients with positive level N2 lymph nodes.
authors.affiliation: Esophagogastric Unit, General and Digestive Surgery Department, Hospital Virgen del Camino, c/o Pintor Maeztu 2, 8C, 31008 Pamplona, Navarra, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Díaz de Liaño
authors.forename: Concepción
authors.initials: C
authors.lastname: Yarnoz
authors.forename: Rubén
authors.initials: R
authors.lastname: Aguilar
authors.forename: Cristina
authors.initials: C
authors.lastname: Artieda
authors.forename: Héctor
authors.initials: H
authors.lastname: Ortiz
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*