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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2005

01-02-2005 | Letters to the Editor

It Is Still Not the Time to Change Surgical Strategy for Gastric Cancer

To the Editor

Author: Wei-Jei Lee, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2005

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Excerpt

I read with interest the editorial by Kappas et al.1 The author advocates the application of gastrectomy with D2 lymph node dissection for gastric cancer resection. The recommendation is based on long-term survival findings in the Dutch trial.2 There was a 20% long-term survival rate among N2 patients who had undergone D2 dissection, versus 0% among those who had a D1 resection in the Dutch trial. From these data, the author estimated an overall absolute survival benefit of approximately 6% (30% N2 incidence; 20% N2 survivors) for routine D2 dissection in all patients with curable disease. However, the analysis in the Dutch trial is inappropriate, and the estimation by the author is incorrect. …
Literature
1.
Kappas, AM, Fatouros, M, Roukos, DH 2004Is it time to change surgical strategy for gastric cancer in the United States?Ann Surg Oncol1172730
2.
Hartgrink, HH, van-de Velde, CJ 2003Final results of the Dutch D1 versus D2 gastric cancer trialJ Clin Oncol21206977
3.
Lee, WJ, Hong, RL, Lai, IR,  et al. 2002Reappraisal the new UICC staging system for gastric cancer: problem in lymph node stageHepatogastroenterology498604
4.
Cady, B 1984Lymph node metastasesArch Surg119106772
5.
Lee, WJ 1994Prognostic relevance of systematic lymph node dissection in gastric carcinoma (letter to the editor)Br J Surg813156
6.
Lee, WJ 1995Cancer of the stomach: a review of two hospitals in Korea and Japan (letter to the editor)World J Surg194689
7.
Lee, WJ, Chen, TC, Lai, IR,  et al. 2003Randomized clinical trial of Ligasure versus conventional surgery for extended gastric cancer resectionBr J Surg9014936
8.
Cushieri, A, Weeden, S, Fielding, J,  et al. 1999Patient survival after D1 and D2 resection for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operation GroupBr J Cancer1152230
9.
Wu, CW, Hsiung, CA, Lo, SS,  et al. 2004Randomized clinical trial of morbidity after D1 and D3 surgery for gastric cancerBr J Surg942837
Metadata
Title
It Is Still Not the Time to Change Surgical Strategy for Gastric Cancer
To the Editor
Author
Wei-Jei Lee, MD, PhD
Publication date
01-02-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.10.908

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