Efficacy of extended lymphadenectomy in the noncurative gastrectomy for advanced gastric cancer

BACKGROUND/AIMS: We retrospectively analyzed clinicopathologic data on 83 p atients with advanced gastric cancer who underwent noncurative gastrectomy, with respect to the relation between the extent of lymphadenectomy and sur vival benefit. METHODOLOGY: These 83 patients were divided into 44 patients with limited o r simple lymph node dissection (D0 in 14 and D1 in 30: Group A) and 39 pati ents with extended lymph node dissection (D2: Group B). RESULTS: The 1-year survival rate in Group B (82.1%) was significantly high er than in Group A (49.0%). However, the 3-year and 5-year survival rates d id not significantly differ between Group A versus Group B, 39.7% versus 25 .7% and 39.7% versus 20.5%, respectively. Median survival time after surger y with and without distant metastasis in Group B (21.5 months) was longer t han in Group A (16.4 months), although not significant. CONCLUSIONS: While gastrectomy with extended lymphadenectomy did not contri bute to improve longterm survival in patients with noncurable advanced gast ric cancer, the utility of extended lymph node dissections may be relevant to improved locoregional control, at least in the prognosis within 1 year a fter surgery. Not only extended lymphadenectomy but also aggressive chemoth erapy may be needed to improve the long-term survival for such patients.