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A Phase-II Clinical Trial of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer Patients

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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 grou**, 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.

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Authors and Affiliations

  1. Center for Gastric Cancer, National Cancer Center, 809 Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 411-769, Korea

    Jun Ho Lee MD, Young-Woo Kim MD, Keun Won Ryu MD, Jong Ryul Lee MD, Chan Gyoo Kim MD, Il Ju Choi MD, Myoung Cheorl Kook MD & Jae-Moon Bae MD

  2. Cancer Biostatistics Branch, Research Institute for National Cancer Control & Evaluation, National Cancer Center, Gyeonggi-do, Goyang-si, Gyeonggi-do, 411-769, Korea

    Byung-Ho Nam PhD

Authors
  1. Jun Ho Lee MD
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  2. Young-Woo Kim MD
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  4. Jong Ryul Lee MD
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  5. Chan Gyoo Kim MD
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  9. Jae-Moon Bae MD
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Correspondence to Young-Woo Kim MD.

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Lee, J.H., Kim, YW., Ryu, K.W. et al. A Phase-II Clinical Trial of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer Patients. Ann Surg Oncol 14, 3148–3153 (2007). https://doi.org/10.1245/s10434-007-9446-0

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  • DOI: https://doi.org/10.1245/s10434-007-9446-0

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