Results of D2 gastrectomy for gastric adenocarcinoma: 10-year experience in Thai patients
Euanorasetr, C.; Lertsithichai, P.
Journal of the Medical Association of Thailand 90(2): 291-300
2007
ISSN/ISBN: 0125-2208 PMID: 17375634 Document Number: 2731
Background. The therapeutic value of D2 gastrectomy in the curative treatment of gastric adenocarcinoma is controversial outside Japan.Material and Method. The authors retrospectively reviewed the medical records of 97 patients with gastric adenocarcinoma who underwent curative D2 gastrectomy between October 1995 and September 2005.Results: Subtotal gastrectomy was performed in 42/97 patients (43%) and total gastrectomy in 55197 patients (57%), with an average number of 38 lymph nodes (range, 22-82) and 48 lymph nodes (range, 24-126) removed, respectively. Overall morbidity rate was 17% (16/97). There was no hospital mortality. The 5-year overall and 5-year disease-free survival rates were 59% and 46% respectively. The 5-year disease-free survival rate for each TNM stage was 100% for stages IA and IB, 75% for stage II, 78% for stage IIIA, 28% for stage IIIB and 4% for stage IV Of the 43197 patients (44%) who had metastasis to the level 2 (N2) lymph nodes, 141 43 patients (33%) survived more than 5 years.Conclusion: The D2 gastrectomy can be performed with low morbidity and mortality, and may increase the cure rate and survival of Thai gastric adenocarcinoma patients, at least in experienced centers.
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