Extended (D2) lymphadenectomy in gastric cancer: a five year experience

The extent of lymph node dissection in stomach adenocarcinoma is currently under debate. Japanese data strongly support the therapeutic value of exten ded lymphadenectomy (D2 node dissection), whereas in Western countries seve ral prospective trials have recently been completed with contrasting result s. During the period May 1993 to May 1998, 164 patients with gastric cancer were observed: 136 patients, treated with a radical surgical procedure inc luding lymph node dissection according to the guidelines of the Japanese Re search Society for Gastric Cancer, were eligible for our analysis. Clinical , histopathological, and surgical factors were examined for their influence on long-term survival. Our results on morbidity and mortality rates are si milar to Japanese series: we suggest that the experience and training of th e surgeon and his personal attitude towards extensive lymph node dissection may, therefore, be a major factor influencing the morbidity associated wit h the procedure. The relatively high estimated 3-year survival rate (52%) s uggests support for extended lymphadenectomy (D2 dissection) in gastric can cer as standard treatment.