Long-term results following potentially curative gastrectomy for gastric cancer

Purpose: The purpose of this study was to report the results of gastric cancer surgery in patients who had undergone potentially curative gastrectomy. Methods: The hospital mortality, morbidity, survival, recurrences and the sites of failure were retrospectively analyzed in D-1 group (conventional gastrectomy), and in D-2 group (extended lymph node resection). Results: D-1 and D-2 groups were comparable for age, gender, American Society of Anesthesiologists (ASA) class, type of surgery, and histopathologic characteristics (p >0.05). D-2 group patients were in better physical status (p=0.008). The recurrence rate was higher in D-1 group (p=0.019). Independent prognostic indicators of morbidity were male gender (p=0.012), and poor ASA class (p <0.001). Poor ASA class was the single independent prognostic indicator of hospital mortality (p=0.001). Ten-year survival for D-1 and D-2 was 44.1 and 64.8%, respectively (p=0.0433). D-2 gastrectomy improved survival in stage IIIA. The independent prognostic indicators of survival were total gastrectomy (p=0.003), lymph node involvement (p <0.0001), and extended lymphadenectomy (p=0.003). The independent prognostic variables of recurrence were stage (p=0.001), and extended lymph node resection (p=0.006). Conclusion: D-2 gastrectomy improves survival in gastric cancer; particularly in stage IIIA.