A.A. Chernyavskiy1, N.A. Lavrov1, A.V. Maslennikova1, V.V. Ershov2
1Volga Region Research Medical University, Nizhny Novgorod
2Nizhny Novgorod Regional Clinical Oncology Center, Nizhny Novgorod
Chernyavsky A.A. ― D. Sc. (Medicine), Professor of the Department of Oncology, radiation therapy and radiology of Volga Region Research Medical University
1 Ankudinovskoe highway, Nizhny Novgorod, Russian Federation, 603081, tel.: (831) 465-34-54, +7-910-385-79-85, e-mail: firstname.lastname@example.org
Abstract. The experience of 1528 resection interventions in gastric cancer (GC), supplemented with lymph node dissection (LD) in the volumes: D1 (n=751), D2 (n=241), D2.5 (n=359), D3 (n=177). Unconventional symbol D2.5 reflects the extent of LD D2 complemented by a circular dissection of ligament hepatoduodenale and the upper retropancreatic LN and omentobursectomy with inclusion in the preparation of LN of the hiatus of the diaphragm. The analysis of immediate and long-term results is presented. It is established that the benefit of D2 over D3 in the accuracy of gastric cancer staging is minimal. LD D3 is accompanied by the highest frequency of complications, especially purulent and pancreatogenic. LD in volume D2.5 compared with D2, it significantly increases the 5-year survival rate of patients (64.0±4.1% vs 51.2±4.9%, p<0.001) and should be the method of choice in any radical surgery for GC, including early forms; the exception is localized proximal cancers, for which metastasis in the hepatoduodenal ligament is not characteristic. LD D3 compared to D2.5 did not affect survival rates; only in patients with antral cancer after distal subtotal gastric resection increased 5-year survival rate by 8% (from 60.6±7.5% to 68.5±6.3%).
Key words: gastric cancer, surgical treatment, lymph node dissection.