| Comparison of Clinical Outcome in Para-aortic Lymph Node Dissection (PALD) and D2 for Advanced Gastric Cancer |
| Chan Dong Kim, Dae Hyun Yang, Ik Haeng Jo, Jin Pok Kim, Won Jin Choi, Il Myung Kim, Jin Youn, Sang Su Park, Byung Ook Yoo, Seung Ik Ahn, Sin Eun Choi |
1Departments of Surgery, Kangnam General Hospital Public Corporation, Seoul, Korea. dhyang@kangnamhosp.or.kr
2Departments of Pathology, Kangnam General Hospital Public Corporation, Seoul, Korea.
3Inje University Seoul Paik Medical Center Korea Gastric Cancer Center, Korea.
4Department of Surgery, College of Medicine, Gangwon National University, Korea.
5Department of Surgery, College of Medicine, Inha University, Korea.
6Department of Surgery, Seoul Dongbu Municipal Hospital, Seoul, Korea.
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| ABSTRACT |
PURPOSE:
We compared the clinical results of paraaortic lymph node dissection (PALD) with those of D2 to evaluate the survival gain and disadvantage of paraaortic lymph node dissection for advanced gastric cancer.
MATERIALS AND METHODS:
We analysed the clinical data of 196 patients who underwent curative resection and D2 with or without paraaortic lymph node dissection (PALD or D2) for advanced gastric cancer from May 1990 to June 1999. The operative factors (operative time, the amounts of intraoperative transfusion and hospital stay), operative morbidity and mortality and 5 year survival rates were compared between D2 and PALD groups.
RESULTS:
The operative time of subtotal gastrectomy was significantly longer in PALD group than D2 group. The operative morbidity rates were 9.2% in D2 group and 10.3% in PALD group.
There were 3 operative mortalities in D2 group and none in PALD group. The 5 year survival rates (5YSR's) of stage IB, II, IIIA, IIIB, IV were 88.9%, 92.3%, 30.2%, 24.2%, 28.9% in D2 group and 93.3%, 75.5%, 61.0%, 0%, 0% in PALD group.
CONCLUSION:
The paraaortic lymph node dissection was a rather safe procedure without significant increase of morbidity and mortality. There was no statistically significant difference in survival in any stage of this retrospective study with limited cases and follow-ups. |
| Key words:
Stomach neoplasm;Paraaortic lymph node dissection;D2 dissection;Survival;Operative complication |
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