Document Detail


Routine modified D2 lymphadenectomy performance in pT1-T2N0 gastric cancer.
MedLine Citation:
PMID:  19938196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate routine modified D2 lymphadenectomy in gastric cancer, based on immunohistochemically detected skip micrometastases in level II 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 II 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 IA to IB in one patient and from stage IB 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.
Authors:
John Griniatsos; Hara Gakiopoulou; Eugenia Yiannakopoulou; Nikoletta Dimitriou; Gerasimos Douridas; Afrodite Nonni; Theodoros Liakakos; Evangelos Felekouras
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  15     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-24     Revised Date:  2010-09-28    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  5568-72     Citation Subset:  IM    
Affiliation:
1st Department of Surgery, University of Athens, Medical School, LAIKO Hospital, Athens, Greece. johngriniatsos@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis*,  pathology*
Aged
Female
Humans
Immunohistochemistry / methods
Lymph Node Excision / methods*
Lymph Nodes / pathology
Lymphatic Metastasis / diagnosis*
Male
Middle Aged
Neoplasm Staging / methods
Prognosis
Stomach Neoplasms / diagnosis*,  pathology*,  surgery
Treatment Outcome
Comments/Corrections

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