Is extended lymphadenectomy valuable in palliatively gastrectomized patients with gastric cancer and simultaneous peritoneal metastasis?

Background/Aims: The optimal extent of lymphadenectomy in patients with gas tric cancer and simultaneous peritoneal metastasis upon non-curative resect ion remains unclear. The aim of the present study was to evaluate the effic acy of extended lymphadenectomy in palliatively gastrectomized patients wit h gastric cancer and simultaneous peritoneal metastasis. Methodology: The significance and limit of extended lymphadenectomy accordi ng to the extent of peritoneal metastasis was analyzed retrospectively in 1 10 patients with gastric cancer rind simultaneous peritoneal metastasis who had undergone palliative gastrectomy. Results: Of the 47 patients with P1 metastasis, the median survival period of the :23 patients who underwent extended lymphadenectomy and the 24 patie nts who underwent limited lymphadenectomy was 21.7 months and 17.2 months, respectively. Of the 63 patients with P2 or P3 metastasis, the median survi val period of the 16 patients who underwent extended lymphadenectomy and th e 47 patients who underwent limited lymphadenectomy was 10.4 months and 12. 8 months, respectively. No significant differences in survival time based o n extent of lymphadenectomy were observed either in the patients with P2 or P3 metastasis (P=0.262) or in those with P1 metastasis (P=0.277). Conclusions: The results of the present study demonstrate that extended lym phadenectomy in gastric cancer yields no positive impact on survival upon n on-curative resection either in patients with gastric cancer and simultaneo us metastases to the adjacent peritoneum (P1) or to the distant peritoneum (P2 or P3).