Long-term benefit of extended lymphadenectomy with gastrectomy in distallylocated early gastric carcinoma

BACKGROUND: Extended lymphadenectomy performed with gastrectomy has been re ported to prolong survival of patients with early gastric cancer. However, some authors question the value of extensive lymphadenectomy in these patie nts, especially since much recent discussion of patient quality of life aft er gastrectomy has favored less invasive operations. METHODS: We retrospectively analyzed 485 patients who had undergone gastrec tomy for early cancer in order to evaluate the effect of extended versus li mited lymphadenectomy on postoperative survival. Various prognostic factors were examined for patients whose tumors were located in the distal third o f the stomach. RESULTS: Although extended radical lymphadenectomy did not prolong postoper ative survival when early gastric cancer was located in the middle or proxi mal third of the stomach,, it did when the tumor occupied the distal third. CONCLUSIONS: Performance of extended radical lymphadenectomy was a signific ant prognostic factor for early gastric cancer patients when tumors were lo cated in the distal third of the stomach. Am J Surg. 2000;180:127-132. (C) 2000 by Excerpta Medica, Inc.