Abstract:
BACKGROUND:Despite advances in the treatment of patients with gastric cancer, the debate over the optimal extent of lymphadenectomy continues. METHOD:A review of the classification, rationale for, and boundaries of lymphadenectomy is presented. A review of the available literature comparing D1 versus D2 versus D3 lymphadenectomy was performed and included randomized controlled trials, and prospective and retrospective comparative and non-comparative studies. RESULTS:Earlier studies demonstrated increased morbidity with D2 compared with D1 lymphadenectomy, with no significant survival benefit. More recent studies have demonstrated survival benefit of a pancreas and spleen-sparing D2 lymphadenectomy in patients with advanced, node-positive tumors. Para-aortic/D3 dissections contribute to increased morbidity, with no survival benefit. CONCLUSIONS:In patients with resectable gastric adenocarcinoma, a D2 lymph node dissection preserving the pancreas and spleen should be considered standard for optimal staging and treatment, provided it is performed by surgeons with sufficient expertise. Extended lymph node dissections beyond D2 should not be routinely performed as it has been shown to have increased morbidity, with no improvement in outcomes. While systemic chemotherapy should be considered standard in patients undergoing D2 lymphadenectomy, the role of adjuvant radiation continues to evolve.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Mogal H,Fields R,Maithel SK,Votanopoulos Kdoi
10.1245/s10434-019-07417-5subject
Has Abstractpub_date
2019-09-01 00:00:00pages
2912-2932issue
9eissn
1068-9265issn
1534-4681pii
10.1245/s10434-019-07417-5journal_volume
26pub_type
杂志文章abstract:BACKGROUND:This study was designed to describe patient, disease, and treatment characteristics of women diagnosed with breast cancer at the Breast Examination Center of Harlem (BECH) and to determine whether these characteristics have changed over time. METHODS:Retrospective chart review of women diagnosed with breast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4240-2
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:A microscopically irradical (R1) resection is a well-known adverse prognostic factor after gastric cancer surgery. However, the prognostic significance of an R1 resection in gastric cancer patients who are treated with chemoradiotherapy (CRT) after the operation has been poorly studied. Therefore, the aim of...
journal_title:Annals of surgical oncology
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doi:10.1245/s10434-013-3397-4
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9370-3
更新日期:2007-08-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02306378
更新日期:1995-09-01 00:00:00
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doi:10.1245/s10434-015-4885-5
更新日期:2016-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1245/s10434-014-3722-6
更新日期:2014-09-01 00:00:00
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journal_title:Annals of surgical oncology
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 社论
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更新日期:2019-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2020-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4234-0
更新日期:2015-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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更新日期:2015-10-01 00:00:00
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journal_title:Annals of surgical oncology
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更新日期:2009-11-01 00:00:00
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更新日期:2014-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4108-5
更新日期:2015-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6767-0
更新日期:2018-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5741-y
更新日期:2017-06-01 00:00:00
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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更新日期:2018-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4380-z
更新日期:2015-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5292-2
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Surgical resection is the standard treatment for hepatocellular carcinoma (HCC). However, the role of surgery in treatment of large tumors (10 cm or more) is controversial. We have analyzed, in a single centre, the long-term outcome associated with surgical resection in patients with such large tumors. METH...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9518-1
更新日期:2007-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2015-05-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9831-3
更新日期:2008-06-01 00:00:00