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A Journal on Surgery

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Chirurgia 2004 October;17(5):157-60

language: Italian

Role of lymphadenectomy in gastric cancer surgery

Ponsetto M., Panier Suffat L., Ceresa F., Bergantino A., R. Scala R., Colombo R., Peradotto F., Personnettaz E., Obialero M.


Aim. The incidence of gastric cancer in Western countries is at present decreasing, only in geriatric age the prevalence of advanced stages is still high.
Methods. From January 1992 to December 2002, 97 patients with gastric cancer have been submitted to resection surgery. The patients have been classified according to TNM in 3 categories: early gastric cancer, neoplasia in an early stage and advanced cancer. Survival results have been verified with x2 test. D2 lymphadenectomy was applied according to patient's characteristics, often in geriatric age and affected by important comorbility. A D1 lymphadenectomy, extended to celiac and hepatic lymphatic sites, was often performed.
Results. Splenectomy and extension of the neoplasm to the pancreatic body seem to be associated with a worse prognosis. Survival seems to be strongly associated to the disease stage at diagnosis. Lymph node metastases and tumor originating from cardias are negative prognostic factors.
Conclusion. In early stages survival is good and a D2 lymphadenectomy is mandatory; in advanced cancer, surgery has a lower impact on survival.

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