Role of Extended Lymphadenectomy in Cancer of the Gastrointestinal Tract

Abstract

The prognosis for many cancers of the gastrointestinal tract has remained the same for the last 20 years, and surgery is still the mainstay of treatment. In order to improve survival, surgeons have continued to explore the role of a more extensive resection, and in particular, the role of a more extensive lymphadenectomy. This technical aspect remains one of the most controversial issues in the treatment of cancers of the gastrointestinal tract. A review of the literature in the last 30 years shows how this topic has been debated over and over without reaching a definitive conclusion. The basic questions are still the same: does an extended lymphadenectomy increase survival? And in the absence of a definitive answer, is the increased morbidity and mortality justified? The International Society of Digestive Surgery (ISDS) has put together a panel of experts trying to shed light on the role of extended lymphadenectomy for cancers of the esophagus, stomach, pancreas, colon, and rectum. For each type of cancer, the evidence in favor and against an extended lymphadenectomy will be discussed. It will be then up to the individual surgeons to decide how to apply this information to their practice. The readers will have the opportunity to listen to these presentations live and ask questions to the Authors during M. G. Patti (&) International Society of Digestive Surgery (ISDS), University of Chicago Pritzker School of Medicine, 5841 South Maryland Avenue, Room G-207, Chicago, IL 60637, USA e-mail: mpatti@surgery.bsd.uchicago.edu