Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis

Anticancer Res. 2019 Nov;39(11):6209-6216. doi: 10.21873/anticanres.13829.

Abstract

Background: The appropriate extent of lymphadenectomy on gastric cancer patients with positive peritoneal cytology (CY1) is uncertain. This study retrospectively compared overall survival (OS) after standard and limited lymphadenectomy.

Patients and methods: The medical records from four institutions from 2004 to 2018 were reviewed and data for 91 patients with CY1, but no other distant metastases, who underwent gastrectomy were analyzed. D2 or greater lymphadenectomy and less than D2 lymphadenectomy were performed in 51 and 40 patients, respectively.

Results: Full cohort analyses showed that patients who underwent D2 or greater lymphadenectomy had better prognostic nutritional indices and more such patients received postoperative chemotherapy. The OS in the group treated with D2 or greater lymphadenectomy was also significantly better (p=0.045). Twenty-seven pairs of patients were generated via propensity score matching, and analysis of their OS showed no significant difference between the groups according to lymphadenectomy (p=0.61).

Conclusion: The extent of lymphadenectomy may not affect the prognoses for patients with CY1 gastric cancer.

Keywords: Cell biology; lymph node excision; stomach neoplasms.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cause of Death
  • Female
  • Gastrectomy / methods
  • Gastrectomy / mortality
  • Humans
  • Lymph Node Excision / methods*
  • Lymph Node Excision / mortality
  • Male
  • Middle Aged
  • Nutritional Status
  • Peritoneum / pathology
  • Prognosis
  • Propensity Score
  • Retrospective Studies
  • Statistics, Nonparametric
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Survival Rate
  • Time Factors