Prognostic factors in gastric carcinoma after R0 resection with DII lymph node dissection. Tunisian experience.
Keywords:
Cancer stomach surgery, curative resection, lymphadenectomyAbstract
Background: Curative resection with adequate lymph node dissection is the treatment of choice for gastric cancer.Aim: To determine the prognostic factors after R0 resection with DII lymph node dissection.
Methods: We retrospectively assessed 126 patients who underwent R0 resection with DII lymph node dissection for gastric cancer (excluding the upper third of the stomach) in a single institution between 1991 and 2006 with median follow-up of 38.5 months (6 – 219). Prognostic factors were assessed by Cox proportional hazard model.
Results: There were 45 women and 81 men. The median age was 60 years (21 – 87). Four patients died (3.2 %). Postoperative hospital morbidity was 16.7 %. The pathologic review of the slides revealed that 50% of the tumors were stage T3 (63 cases). The median number of lymph node removed was 11 (8-40), 50% were involved. Five and 10 years survival rates were respectively 56.9 % and 40.2 %. In multivariable analysis, depth of wall invasion, lymph node involvement and more than 15 retrieved lymph nodes were found to be independent prognosis factors.
Conclusion: After R0 resection with DII lymphadenectomy, depth of wall invasion, lymph node involvement and more than 15 retrieved lymph nodes were independent predictive factors for survival.
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References
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