Low rates of loco-regional recurrence following extended lymph node dissection for gastric cancer

A. Muratore, G. Zimmitti, R. Lo Tesoriere, A. Mellano, P. Massucco, L. Capussotti

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Aim: The study by MacDonald et al. [Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30] has reported low loco-regional recurrence rates (19%) after gastric cancer resection and adjuvant radiotherapy. However, the lymph node dissection was often "inadequate". The aim of this retrospective study is to analyse if an extended lymph node dissection (D2) without adjuvant radiotherapy may achieve comparable loco-regional recurrence rates. Methods: A prospective database of 200 patients who underwent a curative resection for gastric carcinoma from January 2000 to December 2006 was analysed. D2 lymph node dissection was standard. Recurrences were categorized as loco-regional, peritoneal, or distant. No patients received neoadjuvant or adjuvant radiotherapy. Results: The in-hospital mortality rate was 1% (2 patients). The mean number of dissected lymph nodes was 25.9. Overall and disease-free survival at 5 years were 60.7% and 61.2% respectively. During the follow-up, 60 patients (30%) have recurred at 76 sites: 38 (50%) distant metastases, 25 (32.9%) peritoneal metastases, and 13 (17.1%) loco-regional recurrences. The loco-regional recurrence was isolated in 6 patients and associated with peritoneal or distant metastases in 7 patients. The mean time to the first recurrence was 18.9 (95% confidence interval: 15.0-21.9) months. Conclusions: Extended lymph node dissection is safe and warrants low loco-regional recurrence rates.

Original languageEnglish
Pages (from-to)588-592
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2009

Fingerprint

Lymph Node Excision
Stomach Neoplasms
Recurrence
Adjuvant Radiotherapy
Neoplasm Metastasis
Stomach
Esophagogastric Junction
Chemoradiotherapy
Hospital Mortality
Disease-Free Survival
Adenocarcinoma
Retrospective Studies
Lymph Nodes
Databases
Confidence Intervals
Carcinoma
Mortality

Keywords

  • Gastric cancer
  • Lymph nodes
  • Radiotherapy
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Low rates of loco-regional recurrence following extended lymph node dissection for gastric cancer. / Muratore, A.; Zimmitti, G.; Lo Tesoriere, R.; Mellano, A.; Massucco, P.; Capussotti, L.

In: European Journal of Surgical Oncology, Vol. 35, No. 6, 06.2009, p. 588-592.

Research output: Contribution to journalArticle

Muratore, A. ; Zimmitti, G. ; Lo Tesoriere, R. ; Mellano, A. ; Massucco, P. ; Capussotti, L. / Low rates of loco-regional recurrence following extended lymph node dissection for gastric cancer. In: European Journal of Surgical Oncology. 2009 ; Vol. 35, No. 6. pp. 588-592.
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abstract = "Aim: The study by MacDonald et al. [Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30] has reported low loco-regional recurrence rates (19{\%}) after gastric cancer resection and adjuvant radiotherapy. However, the lymph node dissection was often {"}inadequate{"}. The aim of this retrospective study is to analyse if an extended lymph node dissection (D2) without adjuvant radiotherapy may achieve comparable loco-regional recurrence rates. Methods: A prospective database of 200 patients who underwent a curative resection for gastric carcinoma from January 2000 to December 2006 was analysed. D2 lymph node dissection was standard. Recurrences were categorized as loco-regional, peritoneal, or distant. No patients received neoadjuvant or adjuvant radiotherapy. Results: The in-hospital mortality rate was 1{\%} (2 patients). The mean number of dissected lymph nodes was 25.9. Overall and disease-free survival at 5 years were 60.7{\%} and 61.2{\%} respectively. During the follow-up, 60 patients (30{\%}) have recurred at 76 sites: 38 (50{\%}) distant metastases, 25 (32.9{\%}) peritoneal metastases, and 13 (17.1{\%}) loco-regional recurrences. The loco-regional recurrence was isolated in 6 patients and associated with peritoneal or distant metastases in 7 patients. The mean time to the first recurrence was 18.9 (95{\%} confidence interval: 15.0-21.9) months. Conclusions: Extended lymph node dissection is safe and warrants low loco-regional recurrence rates.",
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AU - Lo Tesoriere, R.

AU - Mellano, A.

AU - Massucco, P.

AU - Capussotti, L.

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N2 - Aim: The study by MacDonald et al. [Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30] has reported low loco-regional recurrence rates (19%) after gastric cancer resection and adjuvant radiotherapy. However, the lymph node dissection was often "inadequate". The aim of this retrospective study is to analyse if an extended lymph node dissection (D2) without adjuvant radiotherapy may achieve comparable loco-regional recurrence rates. Methods: A prospective database of 200 patients who underwent a curative resection for gastric carcinoma from January 2000 to December 2006 was analysed. D2 lymph node dissection was standard. Recurrences were categorized as loco-regional, peritoneal, or distant. No patients received neoadjuvant or adjuvant radiotherapy. Results: The in-hospital mortality rate was 1% (2 patients). The mean number of dissected lymph nodes was 25.9. Overall and disease-free survival at 5 years were 60.7% and 61.2% respectively. During the follow-up, 60 patients (30%) have recurred at 76 sites: 38 (50%) distant metastases, 25 (32.9%) peritoneal metastases, and 13 (17.1%) loco-regional recurrences. The loco-regional recurrence was isolated in 6 patients and associated with peritoneal or distant metastases in 7 patients. The mean time to the first recurrence was 18.9 (95% confidence interval: 15.0-21.9) months. Conclusions: Extended lymph node dissection is safe and warrants low loco-regional recurrence rates.

AB - Aim: The study by MacDonald et al. [Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30] has reported low loco-regional recurrence rates (19%) after gastric cancer resection and adjuvant radiotherapy. However, the lymph node dissection was often "inadequate". The aim of this retrospective study is to analyse if an extended lymph node dissection (D2) without adjuvant radiotherapy may achieve comparable loco-regional recurrence rates. Methods: A prospective database of 200 patients who underwent a curative resection for gastric carcinoma from January 2000 to December 2006 was analysed. D2 lymph node dissection was standard. Recurrences were categorized as loco-regional, peritoneal, or distant. No patients received neoadjuvant or adjuvant radiotherapy. Results: The in-hospital mortality rate was 1% (2 patients). The mean number of dissected lymph nodes was 25.9. Overall and disease-free survival at 5 years were 60.7% and 61.2% respectively. During the follow-up, 60 patients (30%) have recurred at 76 sites: 38 (50%) distant metastases, 25 (32.9%) peritoneal metastases, and 13 (17.1%) loco-regional recurrences. The loco-regional recurrence was isolated in 6 patients and associated with peritoneal or distant metastases in 7 patients. The mean time to the first recurrence was 18.9 (95% confidence interval: 15.0-21.9) months. Conclusions: Extended lymph node dissection is safe and warrants low loco-regional recurrence rates.

KW - Gastric cancer

KW - Lymph nodes

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