Efficacy of prophylactic extended lymphadenectomy with gastrectomy for patients with node-negative advanced gastric carcinoma.
OBJECTIVE
Extended lymphadenectomy with gastrectomy is widely performed for patients with advanced gastric carcinoma. However, the therapeutic value of prophylactic extensive lymphadenectomy in patients with node-negative advanced gastric cancer is controversial.


METHODS
We retrospectively analyzed 221 patients who underwent curative gastrectomy for advanced gastric carcinoma without lymph node metastasis to evaluate the effect of prophylactic extended lymphadenectomy on postoperative survival. The postoperative survival rate of patients who underwent extended lymphadenectomy was compared with that of patients who underwent limited lymphadenectomy. Predictive risk factors for tumor recurrence and recurrent patterns also were analyzed.


RESULTS
Extended lymphadenectomy improved the postoperative survival rate of patients with advanced tumors even when lymph node spread was absent. Whether or not prophylactic extended lymphadenectomy was performed significantly affected tumor recurrence in patients with node-negative advanced gastric carcinoma.


CONCLUSIONS
Extensive lymphadenectomy with gastrectomy prolongs survival of patients with node-negative advanced tumors.
Otsuji
Eigo
E
Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. otsuji@koto.kpu-m.ac.jp
Kuriu
Yoshiaki
Y
Ichikawa
Daisuke
D
Ochiai
Toshiya
T
Okamoto
Kazuma
K
Hagiwara
Akeo
A
Yamagishi
Hisakazu
H
D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*