A phase-II clinical trial of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients.

Abstract

OBJECTIVES:

This study was conducted to determine whether laparoscopy-assisted distal gastrectomy (LADG) with complete D2 lymph node dissection for gastric cancer is a safe and effective surgical option.

METHODS:

During an 8-month period, 64 patients, who were diagnosed preoperatively as having T1-2, N0-1 or M0 gastric cancer, were prospectively enrolled to undergo LADG with D2 lymph node dissection; two surgeons with experience of over 50 cases of laparoscopic gastrectomy performed the procedures. The compliance rate, defined as cases with no more than one missing lymph node station according to the Japanese Research Society of Gastric Cancer (JRSGC) lymph node grouping, for the open gastrectomy with D2 lymph node dissection was 66.0% in a pilot study and was used for calculations of sample size. Compliance rate and other surgical outcomes, including the number of retrieved lymph nodes from each lymph node station, morbidities, mortalities and conversion rate, were analyzed.

RESULTS:

The compliance rate was 67.2% and was similar to that of open distal gastrectomy reported in the pilot study. The mean number of retrieved lymph nodes was 50.1 (range 20-100). The most frequently missed lymph node station was no. 5 (31.2%) followed by no. 3 (25.0%). There were no missed lymph nodes at stations no. 6 and 9. The complication rate was 3.1% (2/66); there were two conversions (3.0%) and no mortalities.

CONCLUSIONS:

The current study suggests that LADG with D2 lymph node dissection is oncologically feasible, and phase-III clinical trials will be needed.

• Authors: Jun Ho Lee, Young-Woo Kim, Keun Won Ryu, Jong Ryul Lee, Chan Gyoo Kim, Il Ju Choi, Myoung Cheorl Kook, Byung-Ho Nam, Jae-Moon Bae
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 14 Issue 11 Pg. 3148-53 (Nov 2007) ISSN: 1534-4681 [Electronic] United States
• PMID: 17705092 (Publication Type: Clinical Trial, Phase II, Journal Article)

Topics

• Adenocarcinoma (secondary, surgery)
• Adolescent
• Adult
• Aged
• Feasibility Studies
• Female
• Gastrectomy (methods)
• Humans
• Laparoscopy
• Lymph Node Excision (methods)
• Lymphatic Metastasis
• Male
• Middle Aged
• Prospective Studies
• Stomach Neoplasms (pathology, surgery)