Results of R0 surgery with D2 lymphadenectomy for the treatment of localised gastric cancer.
BACKGROUND
Surgical excision is the best therapeutic option for gastric cancer, provided it is performed with curative intent as R0 surgery. And, according to many authors, D2 lymphadenectomy may be performed with acceptable morbidity and mortality rates.


METHODS
A prospective study was conducted on a series of 126 consecutive cases of gastric cancer treated with gastrectomy and D2 lymphadenectomy. A R0 resection was done in 99 cases (78.6%).


RESULTS
Total gastrectomy was performed in 70 patients and subtotal gastrectomy in 29. The mean number of lymph nodes removed was 32.5 per patient. Suture dehiscence occurred in 3 patients (in one of them in the esophago-jejunal anastomosis). Hospital mortality was 2%. Twenty-six recurrences were detected after a median follow-up of 73.6 months. Five-year actuarial survival was 65%. Five-year survival of patients with positive lymph nodes at the N2 level was 26.5%.


CONCLUSIONS
Gastrectomy with D2 lymphadenectomy may be performed with low morbidity and mortality. R0 resection allows acceptable survival rates to be achieved. There is even a group of patients with invaded lymph nodes at the N2 level surviving at 5 years. It appears to be very important that this surgery is performed by specialised surgeons.
Díaz de Liaño
A
A
Esophago-gastric Unit, Department of General Surgery, Hospital Universitario Virgen del Camino, Pamplona, Navarra, Spain. adiazdea@cfnavarra.es
Yárnoz
C
C
Artieda
C
C
Aguilar
R
R
Viana
S
S
Artajona
A
A
Ortiz
H
H
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate