Prognostic factors in gastric carcinoma after R0 resection with DII lymph node dissection. Tunisian experience.

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Published Nov 26, 2012
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Vol. 90 No. 11 (2012): Issue Nov 2012

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Sofiene Ayadi
Amine Daghfous
Amine Makni
Fadhel Fteriche
Houcine Maghrebi
Wael Rebai
Heykal Bedioui
Faouzi Chebbi
Department of Surgery
Rachid Ksantini
Adel Ammous
Mohamed Jouini
Montassar Kacem
Zoubeir Ben Safta

Abstract

Background: Curative resection with adequate lymph node dissection is the treatment of choice for gastric cancer.
Aim: To determine the prognostic factors after R0 resection with DII lymph node dissection.
Methods: We retrospectively assessed 126 patients who underwent R0 resection with DII lymph node dissection for gastric cancer (excluding the upper third of the stomach) in a single institution between 1991 and 2006 with median follow-up of 38.5 months (6 – 219). Prognostic factors were assessed by Cox proportional hazard model.
Results: There were 45 women and 81 men. The median age was 60 years (21 – 87). Four patients died (3.2 %). Postoperative hospital morbidity was 16.7 %. The pathologic review of the slides revealed that 50% of the tumors were stage T3 (63 cases). The median number of lymph node removed was 11 (8-40), 50% were involved. Five and 10 years survival rates were respectively 56.9 % and 40.2 %. In multivariable analysis, depth of wall invasion, lymph node involvement and more than 15 retrieved lymph nodes were found to be independent prognosis factors.
Conclusion: After R0 resection with DII lymphadenectomy, depth of wall invasion, lymph node involvement and more than 15 retrieved lymph nodes were independent predictive factors for survival.

Keywords:

Cancer stomach surgery, curative resection, lymphadenectomy

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