P-0084 - Does The Number Of Lymph Nodes Removed In Extended D-2 Lymphadenectomy For Gastric Cancer Impact On Survival?

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 L. Monfardini
  • European Institute of Oncology, Milan/IT



This study was designed to investigate whether the number of lymph nodes (LNs) removed offers protection against recurrence and exerts a potentially decisive impact on cancer-specific survival and disease-free survival in patients undergone curative resection for gastric cancer.


A consecutive series of 915 patients (517 males; 398 females; median age: 62 ± 22 years) who underwent gastrectomy and extended lymph node D-2 dissection for gastric cancer between 1994 and 2012, were analyzed. Standard survival methods and restricted cubic spline multivariable Cox regression models were applied.


Median number of dissected LNs was 23. Patients who had <15 nodes removed had significantly worse distant disease-free survival, and overall survival at multivariable analysis than other patients. The results did not change when pT1 and pT2-3 cancer patients were analysed separately. The risk of distant metastases decreased as the number of dissected lymph nodes increased (≥15).


More extended lymph node resection offered survival benefit even in the subgroup of patients with early stage disease. Lymphadenectomy involving more than 15 lymph nodes should be performed for the treatment of also clinically node-negative gastric cancer.