[Lymphadenectomy in surgery for cancers of the stomach and esophagus].
Lymph node invasion is the principal prognostic factor in cancers of the stomach and esophagus which have a tendency to early lymphatic spread.The anatomy of regional lymph node groupings is described and standard and extended types of lymphadenectomy are defined. We discuss he role of lymph node dissection - particularly extended lymphadenectomy - and assess whether there is demonstrable benefit in terms of morbidity and mortality, loco-regional recurrence, and survival. Articles from the surgical literature with the highest levels of evidence are analyzed. Practical guidelines for treatment choice are proposed.
Mariette
C
C
Service de chirurgie digestive et générale, hôpital C.-Huriez, CHRU - Lille. c-mariette@chru-lille.fr
Piessen
G
G
Vons
C
C
D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D019317:Evidence-Based Medicine; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis