J Korean Cancer Assoc.  2000 Oct;32(5):844-851.

Comparison of Clinical Outcome in Para-aortic Lymph Node Dissection (PALD) and D2 for Advanced Gastric Cancer

• Kim CD
• Yang DH
• Jo IH
• Kim JP
• Choi WJ
• Kim IM
• Youn J
• Park SS
• Yoo BO
• Ahn SI
• Choi SE

Abstract

PURPOSE: We compared the clinical results of paraaortic lymph node dissection (PALD) with those of D2 to evaluate the survival gain and disadvantage of paraaortic lymph node dissection for advanced gastric cancer.
MATERIALS AND METHODS
We analysed the clinical data of 196 patients who underwent curative resection and D2 with or without paraaortic lymph node dissection (PALD or D2) for advanced gastric cancer from May 1990 to June 1999. The operative factors (operative time, the amounts of intraoperative transfusion and hospital stay), operative morbidity and mortality and 5 year survival rates were compared between D2 and PALD groups.
RESULTS
The operative time of subtotal gastrectomy was significantly longer in PALD group than D2 group. The operative morbidity rates were 9.2% in D2 group and 10.3% in PALD group. There were 3 operative mortalities in D2 group and none in PALD group. The 5 year survival rates (5YSR's) of stage IB, II, IIIA, IIIB, IV were 88.9%, 92.3%, 30.2%, 24.2%, 28.9% in D2 group and 93.3%, 75.5%, 61.0%, 0%, 0% in PALD group.
CONCLUSION
The paraaortic lymph node dissection was a rather safe procedure without significant increase of morbidity and mortality. There was no statistically significant difference in survival in any stage of this retrospective study with limited cases and follow-ups.

Keyword

Stomach neoplasm; Paraaortic lymph node dissection; D2 dissection; Survival; Operative complication

MeSH Terms

Follow-Up Studies
Gastrectomy
Humans
Lymph Node Excision*
Lymph Nodes*
Mortality
Operative Time
Retrospective Studies
Stomach Neoplasms*
Survival Rate