The American Journal of Surgery
Volume 196, Issue 3 , Pages 358-363 , September 2008

The influence of stage migration on the comparison of surgical outcomes between D2 gastrectomy and D3 gastrectomy (para-aortic lymph node dissection): a multi-institutional retrospective study

  • Chikara Kunisaki, M.D., PhD.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • Corresponding Author InformationCorresponding author. Tel. +81-45-787-2650; fax: +81-45-782-9161
    • ,
  • Masazumi Takahashi, M.D., Ph.D.

      Affiliations

    • Department of Surgery, Yokohama Municipal Hospital, 56 Okazawa-cho Hodogaya-ku, 240-0062, Japan
    • ,
  • Tadao Fukushima, M.D., Ph.D.

      Affiliations

    • Department of Surgery, Yokosuka Kyosai Hospital, 1-16 Yonegawahadori Yokosuka, 238-0011 Japan
    • ,
  • Yutaka Nagahori, M.D., PhD.

      Affiliations

    • Department of Surgery, Yokosuka Kyosai Hospital, 1-16 Yonegawahadori Yokosuka, 238-0011 Japan
    • ,
  • Hirotoshi Akiyama, M.D., Ph.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Hirochika Makino, M.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Yuichi Otsuka, M.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Hidetaka A. Ono, M.D., Ph.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Takashi Kosaka, M.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Ryo Takagawa, M.D.

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
    • ,
  • Hiroshi Shimada, M.D., PhD

      Affiliations

    • Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

Received 25 March 2007 ,Revised 12 July 2007

References 

  1. Nakajima T. Gastric cancer treatment guidelines in Japan. Gastric Cancer. 2002;5:1–5
  2. Cuschieri A, Fayers P, Fielding J, et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomized controlled surgical trial (The Surgical Cooperative Group). Lancet. 1996;347:995–999
  3. Bonenkamp JJ, Songun I, Hermans J, et al. Randomized comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet. 1995;345:745–748
  4. Isozaki H, Okajima K, Fujii K, et al. Effectiveness of paraaortic lymph node dissection for advanced gastric cancer. Hepatogastroenterology. 1999;46:549–554
  5. Baba M, Hokita S, Natsugoe S, et al. Paraaortic lymphadenectomy in patients with advanced gastric carcinoma of the upper-third of the stomach. Hepatogastroenterology. 2000;47:893–896
  6. Kunisaki C, Shimada H, Yamaoka H, et al. Indications for para-aortic lymph node dissection in gastric cancer patients with para-aortic lymph node involvement. Hepatogastroenterology. 2000;47:586–589
  7. Japanese Gastric Cancer Association. Japanese Classification of Gastric Cancer (2nd English edition). Gastric Cancer. 1998;1:8–24
  8. Kunisaki C, Shimada H, Takahashi M, et al. Implication of extended lymph node dissection stratified for advanced gastric cancer. Anticancer Res. 2003;23:4181–4186
  9. Kunisaki C, Hirotoshi A, Masato N, et al. Comparison of surgical results of D2 versus D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric carcinoma: A multi-institutional study. Ann Surg Oncol. 2006;13:659–667
  10. Bunt AMG, Hermans J, Smit VT, van de Velde CJH, Fleuren GJ, Bruijn JA. Surgical/pathologic-stage migration confounds comparisons of gastric cancer survival rates between Japan and Western countries. J Clin Oncol. 1995;13:19–25
  11. In:  Sobin LH,  Wittekind CH editor. TNM: Classification of Malignant Tumours. 6th ed. New York: Wiley-Liss; 2002;
  12. Sasako M, Mcculloch P, Kinoshita T, Maruyama K. New method to evaluate the therapeutic value of lymph node dissection for gastric cancer. Br J Surg. 1995;82:346–351
  13. Siewert JR, Bottcher K, Stein U, et al. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann Surg. 1998;228:449–461
  14. Brennan MF. Lymph node dissection for gastric cancer. N Engl J Med. 1999;340:956–957
  15. Kunisaki C, Shimada H, Yamaoka H, et al. Significance of para-aortic lymph node dissection in advanced gastric cancer. Hepatogastroenterology. 1999;46:2635–2642
  16. Saito H, Osaki T, Murakami D, et al. Macroscopic tumor size as a simple prognostic indicator in patients with gastric cancer. Am J Surg. 2006;192:296–300
  17. Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon (Stage migration and new diagnostic technique as a source of misleading statistics for survival in cancer). N Engl J Med. 1985;312:1604–1608
  18. Yoshikawa T, Sasao M, Sano T, et al. Stage migration caused by D2 dissection with para-aortic lymphadenectomy for gastric cancer form the results of a prospective randomized controlled trial. Br J Surg. 2006;93:1526–1529
  19. Wu CW, Hsiung CA, Lo SS, et al. Stage migration influences on stage-specific survival comparison between D1 and D3 gastric cancer surgeries. Eur J Surg Oncol. 2005;31:153–157
  20. Bonenkamp JJ, Songun I, Hermans J, et al. Randomized comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet. 1995;345:745–748
  21. Cuschieri A, Fayers P, Fielding J, et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomized controlled surgical trial (The Surgical Cooperative Group). Lancet. 1996;347:995–999

PII: S0002-9610(08)00178-5

doi: 10.1016/j.amjsurg.2007.07.031

The American Journal of Surgery
Volume 196, Issue 3 , Pages 358-363 , September 2008

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