Extended Lymphadenectomy Is Associated with a Survival Benefit for Node-Negative Gastric Cancer

被引：75
作者：
Harrison L.E. [1 ]
Karpeh M.S. [2 ]
Brennan M.F. [2 ,3 ]
机构：
[1] Department of Surgery, Univ. Med. and Dent. of New Jersey, New Jersey Medical School, Newark, NJ
[2] Department of Surgery, Mem. Sloan-Kettering Cancer Center, New York, NY
[3] Department of Surgery, Mem. Sloan-Kettering Cancer Center, New York, NY 10021
来源：
Journal of Gastrointestinal Surgery | 1998年 / 2卷 / 2期
关键词：
Gastric Cancer; Early Gastric Cancer; Negative Lymph Node; Node Positivity Rate; Improve Staging Accuracy;
D O I：
10.1016/S1091-255X(98)80002-4
中图分类号：
学科分类号：
摘要：
The purpose of this study was to determine whether extended lymph node (D2) dissection is associated with a survival benefit for patients with histologically node-negative gastric cancer at a single institution in the United States. Review of the prospective gastric database at Memorial Sloan-Kettering Cancer Center from July 1985 to August 1995 identified 774 patients who had undergone curative gastric resection. Of these, 247 patients (32%) were identified with histologically negative lymph nodes by hematoxylin-eosin staining. Data are expressed as median (range). Overall survival was compared by log-rank test. The overall 5-year survival rate for the entire cohort was 79%. The extent of lymph node dissection did not predict survival over the entire cohort. However, when stratified for tumor (T) stage, D2 dissection offered a survival advantage for T3 tumors. The 5-year survival rate for patients with T3 tumors undergoing a D2 dissection (n = 15) was 54% compared to 39% for those undergoing a D1 dissection (n = 53, P <0.05). D2 dissection is associated with improved survival in advanced T stage, node-negative gastric cancer. With adequate staging, results of gastric resection for adenocarcinoma in Western countries begin to approximate those seen in Japan. Excision of N2 lymph nodes may also remove microscopic metastatic disease, contributing to the survival benefit.
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页码：126 / 131
页数：5
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