Journal of Clinical and Investigative Surgery
ISSN: 2559-5555


Long-term survival differences in gastric cancer after D2 lymphadenectomy and an improved assessment of resectability

Gabriel Dimofte1,2, Silviu T. Makkai – Popa1,2, Vlad Porumb1,2, Simona Nicolescu1,2, Sorinel Lunca1,2

1Gr. T. Popa University of Medicine and Pharmacy, Department of Surgery, Iasi, Romania
2Regional Institute for Oncology, Department of Surgery, Iasi, Romania

J Clin Invest Surg. 2017; 2(1): 19-26. DOI: 10.25083/2559.5555.21.1926
Running title: D2 lymphadenectomy and resection in gastric cancer
Keywords: D2 lymphadenectomy, spleen preservation, pancreas preservation


Objective. The purpose of this work is to compare the long-term survival between a control group with mostly D1 lymphadenectomy and a study group with mostly D2 lymphadenectomy.

Materials and Methods. We analyzed consecutive cases operated by a single surgeon performing mostly D2 lymphadenectomy and a control group of consecutive gastric cancer patients operated by a group of surgeons, performing mostly D1 lymphadenectomy, in a period when D2 lymphadenectomy was not the standard and was introduced as a new technique in our center.

Results. We found 30,56% D2 lymphadenectomy in the control groups and 85,1% in the study group. At a five years interval from surgery the control group had no survivors, while the study group had 8 (20%) survivors.

Conclusions. The spleen and pancreas preserving D2 lymphadenectomy done by experienced surgeons, according to the current guidelines in order to select operable patients improves the overall survival of such gastric cancer patients.