Routine modified D2 lymphadenectomy performance in pT1-T2N0 gastric cancer

作     者：John Griniatsos Hara Gakiopoulou Eugenia Yiannakopoulou Nikoletta Dimitriou Gerasimos Douridas Afrodite Nonni Theodoros Liakakos Evangelos Felekouras 

作者机构：1st Department of SurgeryUniversity of AthensMedical School LAIKO HospitalGR 115-27AthensGreece Department of Pathology University of AthensMedical SchoolLAIKO HospitalGR 115-27AthensGreece 3rd Department of SurgeryUniversity of AthensMedical SchoolATTIKO HospitalGR 115-27Athens Greece 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第44期

页      面：5568-5572页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：淋巴结 胃癌 修改 性能 检测 患者 发生率 免疫 

摘      要：AIM:To evaluate routine modified D2 lymphadenectomy in gastric cancer,based on immunohistochemically detected skip micrometastases in levelⅡlymph nodes. METHODS:Among 95 gastric cancer patients who were routinely submitted to curative modified D2 lymphadenectomy,from January 2004 to December 2008,32 were classified as *** levelⅠlymph nodes of these 32 patients were submitted to immunohistochemistry for micrometastases detection. Patients in whom micrometastases were detected in the levelⅠlymph node stations(n=4)were excluded from further *** levelⅡlymph nodes of the remaining 28 patients were studied immunohistochemically for micrometastases detection and constitute the material of the present study. RESULTS:Skip micrometastases in the levelⅡlymph nodes were detected in 14%(4 out of 28)of the patients. The incidence was further increased to 17%(4 out of24)in the subgroup of T1-2 gastric cancer *** micrometastases were detected in the No.7 lymph node ***,the disease was upstaged from stageⅠA toⅠB in one patient and from stageⅠB toⅡin three patients. CONCLUSION:In gastric cancer,true R0 resection may not be achieved without modified D2 lymphadenectomy. Until D2+/D3 lymphadenectomy becomes standard, modified D2 lymphadenectomy should be performed routinely.