The influence of extended lymphadenectomy on survival in patients with gastric cancer

Dobrovolsky N.A. 1, Orel N.A. 1, Lurin A.G. 1, Zgura O.N. 1, Bilenko A.A. 2, Mashukov O.A. 1, Merlych S.V. 1, Ratsiborsky D.V. 1, Maksimovsky V.E.2

Summary. In the period of 2007–2011 188 gastric cancer (GC) patients have been included in the research in abdominal oncosurgical department of Odessa regional oncological dispensary. It was retrospective, one-center, nonrandomized research. Volume of lymph node dissections differed by quantity of lymph nodes to be removed. All patients were divided into three arms. Patients to whom D1 or D1+ lymph node dissections have been performed, totally 90 patients are included in group of historical control. The main group includes 33 patients to whom D3 lymph node dissections is executed and, finally, control group — 65 patients dissected up to the D2 volume. In all cases so-called lymph node dissections for principal reasons have been executed. The multiple-factor analysis of patients survival is implemented depending on a type of a lymph node dissections, a stage of the cancer, number of the involved lymph nodes, involvements of the tumoral microcirculatory net (ly, v), signs of a perinevral invasion (Nev), availability of residual tumoral tissue (R), degree of a differentiation (G). The GC at 60% of patients, regardless of a disease stage, represented with initially hematologicaly disseminated disease. In 40% of cases GC had no signs of intratumoral microcirculatory net involvement, even in the case of more than 15 regional lymph nodes are involved. In the absence of a GC perinevral invasion appeared to be the most precise predictive marker. The conclusion is made some brand new additional prognostic factors could play a crucial role in more accurate patients selection for expanded lymph node dissections.
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