Prognostic benefit of extended radical lymphadenectomy for patients with gastric cancer

Background: The therapeutic value of extensive gastric lymphadenectomy in g astric cancer is controversial. We retrospectively investigated the effect of extended lymphadenectomy on survival in 882 patients with gastric cancel : Materials and Methods: From 882 patients who underwent gastrectomy, DO or DI lymphadenectomy was performed on 137 patients, D2 lymphadenectomy on 52 4 and D3 lymphadenectomy on 221. Curative gastrectomy was performed on 771 patients and the 5-year survival rate of patients had undergone D0 or D1 ly mphadenectomy (D1 group) and that of patients who herd undergone D2 lymphad enectomy (D2 grolcp) was compared with that of patients had undergone D3 ly mphadenectomy (D3 group). Results: In each stage, the 5-year survival rates of patients who had undergone curative operations (n = 771) were compared among the D1, D2 and D3 groups. The 5-year survival rates were as follows: Stage I: n = 510, 89.3% (D1 group: n = 91, 85.8%; D2 group: n = 384, 90.3%; D3 group: n = 35, 88.1%; p = 0.539), Stage II: n = 83, 77.8% (D2 group: n = 35, 82.7%; D3 group: n = 48, 74.3%; p = 0.601), Stage III: n = 133, 50.2% D2 group: n = 46, 39%; D3 group: n = 87 56.1%; p = 0.027), Stage IV: n = 4 5, 8.9% (D2 group: n = 10, 0%; D3 group: n = 35, 11.4%; p = 0.588). Postope rative complications were detected in 10.4% of the cases and the in-hospita l mortality rate was 2.4%. The postoperative morbidity rare of the D3 group (15.8%) was significantly higher than that of the other groups (DI group: 7.3% and D2 group: 9%; p = 0.008). However, the in-hospital mortality rate of the D3 group (1.4%) was not different from that of the other groups (DI group: 3.7% and D2 group: 2.5%; p = 0.374). Conclusion: These results indic ate that D3 lymphadenectomy might be performed as safely as D1 or D2 lympha denectomy on patients with gastric cancer In addition, D3 lymphadenectomy m ight provide a survival benefit for patients with Stage III or Stage IV gas tric cancer.