Lymphadenectomy in gastric carcinoma. A prospective and prognostic study
J. Jaehne, H. J. Meyer, H. Maschek, H. Geerlings, E. Burns and R. Pichlmayr
Department of Surgery, Medical School Hannover, Federal Republic of Germany.
In 193 gastric resections for adenocarcinoma, lymphadenectomy was
prospectively evaluated to quantify the number of lymph nodes and to
identify prognostic factors. Overall, 7112 nodes (median, 36.8 per patient)
were resected with 27.2% showing metastases. Most nodes were found in the
perigastric region. The histologic type and site of the tumor did not
influence the number of invaded nodes, but tumor stage and quality of the
resection (curative/palliative) did. By multivariate analysis the tumor
stage, curative vs palliative resections, and the number of metastatic
lymph nodes in curative resections were independent prognostic factors.
Patients with less than six metastatic nodes showed a survival not
significantly different from that of patients with normal nodes. These
patients may be well treated by surgery alone, but the other patients may
require multimodal therapy to improve their prognosis.
