Comments on the Appropriateness of Extended Resection in Gastric Adenocarcinoma

Abstract

Radical lymphadenectomy for gastric adenocarcinoma is a technique described by a number of Japanese authors as a potential method for improving surgical outcome. This operation has come into vogue at the same time as gastric cancer is appearing at a markedly earlier stage; the improved results claimed most likely are the result of the earlier disease encountered rather than the change in operative strategy. In most other cancers, lymph node metastases are indicators, not governors, of survival, and trials of radical or extensive lymph node resections have failed to improve survival in breast, lung, esophageal, colon, and thyroid cancers and melanoma. It would be unusual if a totally different biologic relation of lymph node metastases were found in gastric carcinoma.