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Feasibility of Total Gastrectomy with D2 Lymphadenectomy for Gastric Cancer and Predictive Factors for Its Short- and Long-Term Outcomes

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The aim of this study was to evaluate the short- and long-term outcomes after total gastrectomy (TG) with D2 lymphadenectomy.

Methods

Patients undergoing TG with D2 lymphadenectomy for gastric cancer between December 2008 and December 2011 were enrolled. Univariate and multivariate analyses were performed to evaluate the risk factors for the short- and long-term outcomes.

Results

A total of 229 patients were analyzed, and 22.3 % developed complications within 30 days of surgery. No patient died within 30 days, while 2.6 % died within 90 days of the operation. In the multivariate analysis, age ≥65 years and cardiopulmonary comorbidities were associated with morbidity, whereas hypoproteinemia and tumor–node–metastasis (TNM) stage III were associated with the disease-free survival (DFS) and overall survival (OS). The number of preoperative risk factors stratified the morbidity from 10.3 % in those without any risk factors to 40.5 % in patients with both risk factors. Similarly, 5-year survival rates decreased from 68.9 % (DFS) and 71.1 % (OS) in those without risk factors to 20.2 % (DFS) and 22.9 % (OS) in patients with both risk factors.

Conclusion

TG with D2 lymphadenectomy has acceptable short- and long-term outcomes. Patient risk stratification may allow for more rational selection of patients and therapeutic strategies for gastric resection.

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Author notes

    Authors and Affiliations

    1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China

      Fan-Feng Chen, Dong-Dong Huang, Jin-Xiao Lu, Chong-Jun Zhou, Cheng-Le Zhuang, Su-Lin Wang, Xian Shen, Zhen Yu & Xiao-Lei Chen

    2. Department of Surgery, Shanghai Tenth People’s Hospital Affiliated to TongJi University, Shanghai, 200072, China

      Zhen Yu

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    1. Fan-Feng Chen
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    Correspondence to Zhen Yu or Xiao-Lei Chen.

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    All participants provided their written informed consent, and the protocol for this study was approved by the ethics committee of The First Affiliated Hospital of Wenzhou Medical University.

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    The authors declare that they have no competing interests.

    Additional information

    Fan-Feng Chen and Dong-Dong Huang contributed equally to this work.

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    Chen, FF., Huang, DD., Lu, JX. et al. Feasibility of Total Gastrectomy with D2 Lymphadenectomy for Gastric Cancer and Predictive Factors for Its Short- and Long-Term Outcomes. J Gastrointest Surg 20, 521–530 (2016). https://doi.org/10.1007/s11605-015-3059-x

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    • DOI: https://doi.org/10.1007/s11605-015-3059-x

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