Prophylactic lymph node dissection in patients with advanced gastric cancer promotes increased survival time

Background. There is no consensus of opinion regarding the efficacy of lymph node dissection. Methods. Data were analyzed from 452 patients with advanced gastric cancer who underwent curative resection in the Department of Surgery 11, Kyushu University Hospital, between 1970 and 1985, with special reference to the lymph node metastasis. Results. Metastatic lesions were evident in the dissected lymph nodes of 300 of 452 (66.4%) patients. Survival time for patients without lymph node metastasis was longer than for those with it (P < 0.01). In patients without lymph node metastasis, the tumor was smaller, serosal invasion was less prominent, tumor growth was less infiltrating, and the tumor stage was, therefore, less advanced. Lymphatic involvement was found in 38.9% of the patients with no evidence of lymph node metastasis. Conclusions. Because the postoperative mortality rate is low in patients with lymph node dissection, the authors advocate prophylactic lymph node dissection to prevent a recurrence. Cancer 1992; 70:392–395.