Status of extended lymph node dissection: Locoregional control is the only way to survive gastric cancer

被引:69
作者
Hartgrink, HH [1 ]
Van de Velde, CJH [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Surg, NL-2300 RC Leiden, Netherlands
关键词
gastric cancer; lymph node dissection; pancreatico-splenectomy; volume; age;
D O I
10.1002/jso.20222
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
There are many factors that are of influence on gastric cancer treatment. The only way to survive is complete locoregional control. More extended dissections should lead to better outcome, but increased morbidity and mortality probably offset its long-term effect in survival in randomised studies. In this article the factors of influence on outcome of gastric cancer treatment such as the extent of lymph node dissection, splenectomy, pancreatectomy, age, volume and additional treatments are discussed. A literature review of these factors in relation to the latest results of the Dutch Gastric Cancer Trials are presented. If morbidity and mortality can be reduced there might be an advantage of extended lymph node dissection. Splenectomy and pancreatectomy should be performed only in case of direct in growth from the tumour into these organs. Centralisation of gastric cancer treatment should be achieved in order to improve results and to facilitate research. By refining selection criteria in the treatment of gastric cancer further improvements are to be expected.
引用
收藏
页码:153 / 165
页数:13
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