title: Subtotal gastrectomy with conventional D2 lymphadenectomy for carcinoma of the distal gastric portion: A retrospective cohort study on clinical outcomes.
abstract: BACKGROUND
  The study was aimed to delineate the postoperative morbidity, mortality and long-term follow-up results after R0 subtotal gastrectomy with D2 lymphadenectomy for invasive non-disseminated adenocarcinoma of the distal gastric portion.
  
  
  METHODS
  Between January 2005 and December 2007, 228 patients with median age at hospitalisation 66.6 ± 11.4 years underwent the above mentioned surgery for histologically proven distal gastric adenocarcinoma.
  
  
  RESULTS
  Postoperative morbidity was documented in 92 (40.4%) of patients within 30 days. An anastomotic leakage was diagnosed in two (0.9%), peritonitis in two (0.9%), anastomositis in five (2.2%), and prolonged ileus in six (2.6%) patients. Nine patients died (3.9%). The overall 1-year survival rate was 83.8%, and the 5-year survival rate was 54.4%. Gender, age, TNM stage, pN, and N ratio were independent factors predicting a long-term prognosis for patients.
  
  
  CONCLUSIONS
  A R0 type distal subtotal gastrectomy with standard D2 lymphadenectomy for a histologically proven invasive adenocarcinoma of the distal gastric portion without distant metastasis offers acceptable postoperative morbidity and mortality, and considerably high overall cumulative 5-year survival rate. The probability of cumulative survival decreases five times when the ratio between metastatic and examined lymph nodes is > 0.25.
authors.affiliation: School of Medicine, Vilnius University, 21 M.K.Ciurlionio str., LT-03101, Vilnius, Lithuania.
authors.forename: Povilas
authors.initials: P
authors.lastname: Kavaliauskas
authors.affiliation: School of Medicine, Vilnius University, 21 M.K.Ciurlionio str., LT-03101, Vilnius, Lithuania.
authors.forename: Rytis
authors.initials: R
authors.lastname: Maziukas
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Vilnius University, National Cancer Institute, 1 Santariskiu Str, LT-08660, Vilnius, Lithuania.
authors.forename: Narimantas Evaldas
authors.initials: NE
authors.lastname: Samalavicius
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Vilnius University, National Cancer Institute, 1 Santariskiu Str, LT-08660, Vilnius, Lithuania.
authors.forename: Justas
authors.initials: J
authors.lastname: Kuliavas
authors.affiliation: Emergency General Surgery and Major Trauma Centre, General Surgery Department, University of Liverpool, Aintree University Hospital NHS Foundation Trust, Lower Lane, Liverpool, L9 7AL, United Kingdom.
authors.forename: Raimundas
authors.initials: R
authors.lastname: Lunevicius
keywords: Distal gastrectomy; Gastric cancer; Long-term survival; Morbidity; Mortality