PURPOSE: This study was designed to investigate whether the number of lymph nodes removed offers protection with a potentially decisive impact on cancer-specific survival and disease-free survival in patients underwent curative resection for gastric cancer. PATIENTS AND METHODS: A consecutive series of 915 patients (517 males; 398 females; median age: 62±22 years) who underwent gastrectomy and extended lymph node D-2 dissection for gastric cancer between 1994 and 2012, was analyzed. Standard survival methods and restricted cubic spline multivariable Cox regression models were applied. RESULTS: median number of dissected LNs was 23. Patients who had <15 nodes removed had significantly worse distant disease-free survival and overall survival at multivariable analysis than other patients. The results did not change when pT1 and pT2-3 cancer patients were analysed separately. The risk of distant metastases decreased as the number of dissected lymph nodes increased (≥15). CONCLUSIONS: more extended lymph node resection offered survival benefit even in the subgroup of patients with early stage disease. Lymphadenectomy involving more than 15 lymph nodes should be performed for the treatment also clinically node-negative gastric cancer.

Does the number of lymphnodes removed in extended D-2 lymphadenectomy for gastric cancer impact on survival? / A. Chiappa, E. Bertani, R. Biffi, M. Venturino, N. Fazio, F. Spada, S. Galdy, C. Ferrari, L. Monfardini, D. Ravizza, F. Maffini, B. Andreoni. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - 25:suppl. 2(2014 Jun), pp. 39-39. ((Intervento presentato al 16. convegno Esmo World Congress on Gastrointestinal Cancer tenutosi a Barcelona nel 2014 [10.1093/annonc/mdu165.80].

Does the number of lymphnodes removed in extended D-2 lymphadenectomy for gastric cancer impact on survival?

A. Chiappa
Primo
;
C. Ferrari;B. Andreoni
2014

Abstract

PURPOSE: This study was designed to investigate whether the number of lymph nodes removed offers protection with a potentially decisive impact on cancer-specific survival and disease-free survival in patients underwent curative resection for gastric cancer. PATIENTS AND METHODS: A consecutive series of 915 patients (517 males; 398 females; median age: 62±22 years) who underwent gastrectomy and extended lymph node D-2 dissection for gastric cancer between 1994 and 2012, was analyzed. Standard survival methods and restricted cubic spline multivariable Cox regression models were applied. RESULTS: median number of dissected LNs was 23. Patients who had <15 nodes removed had significantly worse distant disease-free survival and overall survival at multivariable analysis than other patients. The results did not change when pT1 and pT2-3 cancer patients were analysed separately. The risk of distant metastases decreased as the number of dissected lymph nodes increased (≥15). CONCLUSIONS: more extended lymph node resection offered survival benefit even in the subgroup of patients with early stage disease. Lymphadenectomy involving more than 15 lymph nodes should be performed for the treatment also clinically node-negative gastric cancer.
Gaatric Cancer; D-2 lymphadenectomy; Gastrectomy; disease-free survival
Settore MED/18 - Chirurgia Generale
Settore MED/06 - Oncologia Medica
Settore MED/08 - Anatomia Patologica
Settore MED/12 - Gastroenterologia
giu-2014
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/253768
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