P-0082 - Results After D-2 Resection With Spleen And Distal Pancreas Preserved For Gastric Cancer Treatment

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Antonio Chiappa
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors A. Chiappa1, E. Bertani2, R. Biffi2, N. Fazio2, F. Spada2, M. Venturino2, C. Ferrari3, S. Galdì2, D. Ravizza2, F. Maffini2, B. Andreoni2
  • 1University of Milan -European Intitute of Oncology, Milan/IT
  • 2European Institute of Oncology, Milan/IT
  • 3University of Milan, Milan/IT

Abstract

Introduction

Purpose of this work was to assess surgical morbidity and mortality in a modified D-2 resection for gastric cancer with avoidance of splenectomy and distal pancreatectomy.

Methods

A series of 915 (517 males, 398 females; median age: 62 ± 23 years) consecutive patients with histology-proven gastric cancer underwent gastrectomy and extended D-2 lymphadenectomy for treatment of their disease during an 18-year period (1994-2012) at the European Institute of Oncology in Milano, Italy. Distal pancreas and spleen were routinely preserved, unless the tumor was not closely adjacent to or directly invading these organs. Morbidity, per-operative mortality, and length of hospital stay were recorded.

Results

559 total and 356 subtotal gastrectomies were performed. Splenectomy was performed in 14 cases and spleno-pancreatectomy in 21. The postoperative morbidity rate was 15%, the mortality rate was 1.4%. The median length of stay was 10.8 days.

Conclusion

These results compete favourably with those reported after standard D-1 gastrectomy in Western series. D-2 gastrectomy with spleen and pancreas routine preservation can be considered a safe treatment of this disease.