Extended lymphadenectomy for gastric cancer: a ten year′s experience

Objective To study the operative morbidity and mortality and prognostic benefit of extended lymphadenectomy for the treatment of gastric cancer Methods Between January 1989 and January 1999, 782 patients with primary gastric cancer undergoing gastrectomy with different extent of lymphadenectomy in our hospital were followed up in terms of operative morbidity and mortality and prognostic benefit Results As the whole group the morbidity and mortality rates were 11 6% and 4 1%, respectively Morbidity and mortality rates in D 0/D 1、 D 2 and D 3/D + 3 lymph node dissection were 9 4%、 10 8%、 14 5% ( P 0 05) and 4 3%、 3 0%、 4 6% ( P 0 05), respectively The 5 year survival rate was 38 7%( n =750) The 5 year survival rate of patients undergoing radical resection A and B ( n =561) was 49 9%, that of palliative resection was 5 3% The 5 year survival rate of D 0/D 1、D 2 and D 3/D + 3 lymph node dissection were 30 4% ( n =286), 59 9%( n =197) and 31 8%( n =267), respectively Of stage Ⅲ patients, the 5 year survival rate of D 2 and D 3/D + 3 lymph node dissection were 42 3% ( n =52), and 59 2% ( n =98), respectively ( P 0 05) Conclusion Extended lymphadenectomy could be performed safely, extended lymphadenectomy might provide a survival benefit for patients with gastric cancer, especially in stage Ⅲ