D2 gastrectomy with versus without bursectomy for gastric cancer.
OBJECTIVE
The purpose of this study was to determine the survival benefit of bursectomy by retrospectively comparing the prognosis in patients undergoing D2 lymphadenectomy and gastrectomy (D2 gastrectomy) with bursectomy for gastric cancer with that in patients undergoing D2 gastrectomy alone.


METHODS
A total of 254 consecutive stage IA to IIIC gastric cancer patients undergoing curative intent surgery between 2004 and 2009 were enrolled. The patients were divided into 2 groups: a bursectomy group, which included patients undergoing curative D2 gastrectomy with bursectomy by one surgeon, and a nonbursectomy group, which included those undergoing curative D2 gastrectomy alone by other surgeons.


RESULTS
No statistically significant difference was observed in the number of metastatic nodes or penetration of the serosa between the 2 groups. The overall incidence of surgery-related complications was 24.0% in the bursectomy group (29 of 121 patients) and 25.6% in the nonbursectomy group (34 of 133 patients). The 5-year overall survival rate was 85.8% in the bursectomy group and 80.8% in the nonbursectomy group (hazard ratio 0.82; 95% confidence interval, 0.37-1.74; P=0.60).


CONCLUSIONS
The results of this retrospective study indicate no survival benefit for bursectomy plus D2 gastrectomy over D2 gastrectomy alone.
Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
Mitsugu
M
Kochi
Masashi
M
Fujii
Noriaki
N
Kanamori
Teruo
T
Kaiga
Yoshiaki
Y
Mihara
Tomoya
T
Funada
Hidenori
H
Tamegai
Yuriko
Y
Takayama
Naoki
N
Yoshida
Tadatoshi
T
Takayama
D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008297:Male; D008643:Mesentery / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D009852:Omentum / Q000601:surgery; D061646:Operative Time; D010537:Peritoneum / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome