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Gastrectomy with D2 Lymphadenectomy for Carcinoma of the Stomach in a Stand-alone Cancer Centre in Rural India

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Context

The therapeutic role of D2 lymphadenectomy in the management of gastric cancer is an ongoing controversy.

Aims

To examine the morbidity and oncological outcomes of D2 lymph node dissection for gastric cancer patients treated in a stand-alone cancer center in rural India and to compare it with international data.

Settings and Design

Retrospective study on patients treated for gastric cancer from June 2009 to December 2014.

Methods and Material

All patients underwent subtotal or total gastrectomy with modified D2 lymph node dissection preserving spleen and pancreas. The Clavien-Dindo model was used to stratify the severity of morbidity.

Statistical analysis

Descriptive statistics was used for data exploration. Chi-square test was used to compare the association of various factors with survival. Kaplan-Meier method was used to calculate the survival rates (RFS and DFS). Log-rank test was used to compare the survival of different subgroups.

Results

Fifty-four patients (41 males and 13 females) were included in the study. Four (7.4%) patients had significant postoperative morbidity. The 5-year OS and DFS respectively were 34.9% and 37.6%. Female sex was associated with poorer survival. Lymph node ratio of more than 0.2 and advanced stage at presentation showed strong tendency towards lower OS and DFS.

Conclusions

An R0 resection with D2 lymphadenectomy for gastric cancer carries acceptable morbidity and mortality in Indian patients with survival rates comparable with the western studies. Lymph node ratio more than 0.2 and female gender and advanced stage were associated with poorer oncological outcomes.

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Authors and Affiliations

  1. Department of Surgical Oncology, Malabar Cancer Center, Thalassery, Kerala, 670103, India

    Nizamudheen Mangalasseri Pareekutty, Basavaraj Ankalkoti & Satheesan Balasubramanian

  2. Ruby Hall Clinic, Pune, India

    Sachin Kadam

  3. Department of Cancer Registry, Malabar Cancer Center, Thalassery, Kerala, 670103, India

    Bindu Anilkumar

Authors
  1. Nizamudheen Mangalasseri Pareekutty
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  2. Sachin Kadam
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  3. Basavaraj Ankalkoti
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  4. Satheesan Balasubramanian
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  5. Bindu Anilkumar
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Contributions

Nizamudheen Mangalasseri Pareekutty: concept, study design, write up

Sachin Kadam: data collection, write up

Basavaraj Ankalkoti: data collection, contributed to study

Satheesan Balasubramanian: Concept, supervised the project, editing

Bindu Anilkumar: statistical analysis

Corresponding author

Correspondence to Satheesan Balasubramanian.

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Pareekutty, N.M., Kadam, S., Ankalkoti, B. et al. Gastrectomy with D2 Lymphadenectomy for Carcinoma of the Stomach in a Stand-alone Cancer Centre in Rural India. Indian J Surg Oncol 11, 256–262 (2020). https://doi.org/10.1007/s13193-020-01059-w

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  • DOI: https://doi.org/10.1007/s13193-020-01059-w

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