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. 2020 Jun;11(2):256-262.
doi: 10.1007/s13193-020-01059-w. Epub 2020 May 10.

Gastrectomy with D2 Lymphadenectomy for Carcinoma of the Stomach in a Stand-alone Cancer Centre in Rural India

Nizamudheen Mangalasseri Pareekutty  1 , Sachin Kadam  2 , Basavaraj Ankalkoti  1 , Satheesan Balasubramanian  1 , Bindu Anilkumar  3
Affiliations

Gastrectomy with D2 Lymphadenectomy for Carcinoma of the Stomach in a Stand-alone Cancer Centre in Rural India

Nizamudheen Mangalasseri Pareekutty et al. Indian J Surg Oncol. 2020 Jun.

Abstract

Context: The therapeutic role of D2 lymphadenectomy in the management of gastric cancer is an ongoing controversy.

Aims: To examine the morbidity and oncological outcomes of D2 lymph node dissection for gastric cancer patients treated in a stand-alone cancer center in rural India and to compare it with international data.

Settings and design: Retrospective study on patients treated for gastric cancer from June 2009 to December 2014.

Methods and material: All patients underwent subtotal or total gastrectomy with modified D2 lymph node dissection preserving spleen and pancreas. The Clavien-Dindo model was used to stratify the severity of morbidity.

Statistical analysis: Descriptive statistics was used for data exploration. Chi-square test was used to compare the association of various factors with survival. Kaplan-Meier method was used to calculate the survival rates (RFS and DFS). Log-rank test was used to compare the survival of different subgroups.

Results: Fifty-four patients (41 males and 13 females) were included in the study. Four (7.4%) patients had significant postoperative morbidity. The 5-year OS and DFS respectively were 34.9% and 37.6%. Female sex was associated with poorer survival. Lymph node ratio of more than 0.2 and advanced stage at presentation showed strong tendency towards lower OS and DFS.

Conclusions: An R0 resection with D2 lymphadenectomy for gastric cancer carries acceptable morbidity and mortality in Indian patients with survival rates comparable with the western studies. Lymph node ratio more than 0.2 and female gender and advanced stage were associated with poorer oncological outcomes.

Keywords: D2 lymphadenectomy; Gastrectomy; Lymph node ratio; Stomach cancer.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Cumulative survival
Fig. 2
Fig. 2
Comparison of survival against gender
See this image and copyright information in PMC

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