Routine modified D2 lymphadenectomy performance in pT1-T2N0 gastric cancer
AIM: To evaluate routine modified D2 lymphadenectomy in gastric cancer, based on immunohistochemicaUy detected skip micrometastases in level 11 lymph nodes. METHODS: Among 95 gastric cancer patients who were routinely submitted to curative modified D2 lymphadenectomy, from January 2004 to December 2...
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Veröffentlicht in: | World journal of gastroenterology : WJG 2009-11, Vol.15 (44), p.5568-5572 |
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Sprache: | eng |
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Zusammenfassung: | AIM: To evaluate routine modified D2 lymphadenectomy in gastric cancer, based on immunohistochemicaUy detected skip micrometastases in level 11 lymph nodes.
METHODS: Among 95 gastric cancer patients who were routinely submitted to curative modified D2 lymphadenectomy, from January 2004 to December 2008, 32 were classified as pN0. All level I lymph nodes of these 32 patients were submitted to immunohistochemistry for micrometastases detection. Patients in whom micrometastases were detected in the level Ⅰ lymph node stations (n = 4) were excluded from further analysis. The level 11 lymph nodes of the remaining 28 patients were studied immunohistochemically for micrometastases detection and constitute the material of the present study.
RESULTS: Skip micrometastases in the level Ⅱ lymph nodes were detected in 14% (4 out of 28) of the patients. The incidence was further increased to 17% (4 out of 24) in the subgroup of T1-2 gastric cancer patients. All micrometastases were detected in the No. 7 lymph node station. Thus, the disease was upstaged from stage Ⅰ A to Ⅰ B in one patient and from stage Ⅰ B to Ⅱ in three patients.
CONCLUSION: In gastric cancer, true R0 resection may not be achieved without modified D2 lymphadenectomy. Until D2+/D3 lymphadenectomy becomes standard, modified D2 lymphadenectomy should be performed routinely. |
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ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.15.5568 |