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

Lawrence E. Harrison, Martin S. Karpeh, Murray F. Brennan

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume2
Issue number2
DOIs
StatePublished - Jan 1 1998
Externally publishedYes

Fingerprint

Lymph Node Excision
Stomach Neoplasms
Survival
Dissection
Stomach
Neoplasms
Survival Rate
Hematoxylin
Eosine Yellowish-(YS)
Japan
Adenocarcinoma
Lymph Nodes
Databases
Staining and Labeling

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

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abstract = "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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Extended Lymphadenectomy Is Associated with a Survival Benefit for Node-Negative Gastric Cancer. / Harrison, Lawrence E.; Karpeh, Martin S.; Brennan, Murray F.

In: Journal of Gastrointestinal Surgery, Vol. 2, No. 2, 01.01.1998, p. 126-131.

Research output: Contribution to journalArticle

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