Gastric Cancer

, 10:84 | Cite as

Improved regional control and survival with “low Maruyama Index” surgery in gastric cancer: autopsy findings from the Dutch D1-D2 Trial

  • Scott A. Hundahl
  • Koen C.M.J. Peeters
  • E. Klein Kranenbarg
  • Henk Hartgrink
  • Cornelis J.H. van de Velde
Short communication


Based on more than 11 years of follow-up, autopsy-based analysis of recurrence in the Dutch D1-D2 Trial permits meaningful assessment of patterns of failure with respect to the Maruyama Index (MI). We previously reported that a low Maruyama Index was an independent predictor of both overall and disease-specific survival. Autopsy results are available for 441 deaths on study. Distant-only failure (15% vs 13%) was no different between the MI categories, but isolated “regional” failure (8% for MI < 5 group vs 21%) and “regional + distant” failure (19% for MI < 5 group vs 36%) occurred less frequently in the MI < 5 group (P < 0.001). We conclude that “low Maruyama Index” surgery enhances regional control and survival but does not alter the occurrence of isolated distant metastases unassociated with regional failure. Our results speak to the substantial survival value of local-regional control in this disease.

Key words

Gastric cancer Lymphadenectomy Node Survival Pattern of failure Computer Maruyama Index Autopsy 


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Copyright information

© International and Japanese Gastric Cancer Association 2007

Authors and Affiliations

  • Scott A. Hundahl
    • 1
  • Koen C.M.J. Peeters
    • 2
  • E. Klein Kranenbarg
    • 2
  • Henk Hartgrink
    • 2
  • Cornelis J.H. van de Velde
    • 2
  1. 1.Department of Surgery, University of California at Davis, U.S.A.; and VA Northern California Health Care SystemSacramento VA at MatherMatherUSA
  2. 2.Department of SurgeryLeiden University Medical CenterLeidenThe Netherlands

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