Evaluation advanced lymph node dissection impact on long-term survival rate of gastric cancer patients. Journal of Education

Abstract

Over a period of 2007-2011 188 stomach cancer (SC) patients have been included in the research in abdominal oncosurgical department of Odessa regional oncological dispensary. It was retrospective, one-center, nonrandomized research. Volume of lymph node dissections differed by quantity of lymph nodes to be removed. All patients were divided into three groups. Patients with D1 or D1+ lymph node dissections have been performed, totally 90 patients are included in group of historical control. The main group includes 33 patients to whom D3 lymph node dissections is executed and, finally, control group – 65 patients dissected up to the D2 volume. In all cases so-called lymph node dissections for principal reasons have been executed. The multifactorial analysis of patients survival is implemented depending on a type of a lymph node dissections, a stage of the cancer, number of involved lymph nodes, involvement of the tumoral microcirculatory net (ly is carried out, v) signs of a perinevral invasion (Nev), availability of residual tumoral tissue (R), degree of a differentiation (G). Regardless of a disease stage, SC at 60% of patients, represented with initially hematologicaly disseminated disease. 40% of SC`s had no signs of intratumoral microcirculatory net involvement even in case of more than 15 regional lymph nodes are involved. In the absence of a SC perinevral invasion appeared to be the most precise predictive marker. The conclusion is made some brand new additional53 prognostic factors could play a crucial role in more accurate patients selection for expanded lymph node dissections

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