title: D1 versus D2 Gastrectomy for Gastric Adenocarcinoma.
abstract: BACKGROUND
  Despite the ongoing decrease in the incidence of gastric cancer, this disease is still a major cause of death. It is still debatable whether D2 lymphadenectomy improves survival and whether this procedure should be performed routinely or selectively.
  
  
  OBJECTIVE
  To compare the pathological and short-term results following radical D2-type gastric resection and lymphadenectomy versus the more limited D1 type resection and lymphadenectomy.
  
  
  METHODS
  We conducted a retrospective study on 4 years experience treating 164 patients suffering from gastric cancer. We compared the results between the group of patients who underwent a radical D2 type gastric resection and lymphadenectomy (n = 100) and those of a relatively small group of patients who intentionally underwent the more limited D1 type (n = 34).
  
  
  RESULTS
  The overall number of harvested lymph nodes was 9 ± 4 in the D1 group compared to 30 ± 12 (range 16-69) in the D2 group (P = 0.001). Of the 100 patients undergoing a D2 lymphadenectomy, 57% had positive nodes compared to 38% of the 34 patients in the D1 group (P = 0.045).
  
  
  CONCLUSIONS
  We showed statistically significant differences between D1 and D2 procedures in the overall number of harvested lymph nodes and the proportion of positive nodes to the overall number. Our results support the fact that D2 resection should be recommended as the standard approach of treatment for gastric cancer patients, ensuring a larger number of retrieved lymph nodes and a comparable rate of complications and mortality.
authors.forename: Ron
authors.initials: R
authors.lastname: Lavy
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Hershkovitz
authors.forename: Bar
authors.initials: B
authors.lastname: Chikman
authors.forename: Zahar
authors.initials: Z
authors.lastname: Shapira
authors.forename: Natan
authors.initials: N
authors.lastname: Poluksht
authors.forename: Nirit
authors.initials: N
authors.lastname: Yarom
authors.forename: Judith
authors.initials: J
authors.lastname: Sandbank
authors.forename: Ariel
authors.initials: A
authors.lastname: Halevy
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*