THE EFFECT OF PARA-AORTIC LYMPH NODE DISSECTION IN ADVANCED GASTRIC CANCER

We carried out an analysis of para-aortic lymph node dissection in stage IIIVa advanced gastric cancer to evaluate the extended surgery. The subjects were 32 patients undergoing para-aortic lymph node dissection (D4), and 77 patients undergoing Group 2 and 3 lymph node dissection (D2, 3) which were conducted at the department from 1988 to 1995. No patients with double cancer, liver metastasis, and peritoneal dissemination were involved in the subjects. In case of stage IIIIIb advanced gastric cancer, the 5-year survival rate of patients with D4 (79.5%) was significantly higher than that of patients with D2, 3 (p<0.05). But, as to the prognosis in cases of stage IVa gastric cancer, no statistical differences were found between D4 and D2, 3. Even in cases of stage IIIIIb advanced gastric cancer with n1, 2 involvement, the 5-year survival rate of patients with D4 was significantly higher than that of patients with D2, 3 (p<0.05). These results suggest that D4 dissection is indicated for stage IIIIIb advanced gastric cancer with n2 involvement.