Abstract
BACKGROUND AND AIM: Lymph node dissection in gastric cancer had been controversial, but recent data have led us to the conclusion that D-2 dissection should be the standard of care for potentially curable advanced gastric carcinoma. In this study, we present our single-institution experience of D-2 lymph node dissection. METHODS: From January 2013 to September 2018, 115 patients of gastric cancer were treated with D-2 gastrectomy, 91 of whom met the criteria for study analysis. Data were statistically described as frequencies and percentages where appropriate. Survival curves were plotted using the Kaplan-Meier method, and Cox regression was used to assess the risk among groups. A P value <0.05 was considered to be statistically significant at 95% confidence interval. RESULTS: The majority of patients (86.8%) had Clavien-Dindo grade I postoperative surgical complications; 90-day mortality was seen in five (5.5%) patients. Patients with stages I, II, and III had survival rates of 100%, 71.4%; 53.2%, 44.4%; and 27.8%, 28.1%, respectively, for ages <55 and >55 years. Overall recurrence free survival rates were 26 and 28% for <55 years and >55 years, respectively, with a P value of 0.570. On multivariate analysis, positive distal margin and multivisceral resection had a statistically significant hazard ratio. CONCLUSIONS: This retrospective study conducted in our institute on patients with gastric cancer undergoing D-2 lymphadenectomy has shown that the addition of D-2 lymph node dissection, when performed at high-volume centers, have acceptable morbidity and mortality rates. This can be seen from our grades of postoperative surgical complications, 90-day mortality, and overall 5-year survival.