Beyond D2 Lymphadenectomy in Gastric Cancer
Speaker
 | Inian SAMARASAM Professor and Head Division of Surgery Upper GI Surgery unit Christian Medical Centre, India |
Talk Abstract
Gastric cancer ranks as the fifth most common cancer amongst males and the seventh most common cancer amongst females, in India. While progress has been made in screening and preventive aspects, gastric cancer is often seen at a late stage in the sub-continent. Despite the advances in chemo and immune therapy, definitive surgical treatment currently plays the key role in the cure for this disease.
The optimal extent of lymphadenectomy for Gastric Cancer has been a topic of debate in the past decade. Adequate lymphadenectomy is necessary for disease staging , removal of potentially metastatic LN, better locoregional control, all of which translate into potential survival benefit. It is also known that the survival probability in patients with the same number of involved nodes is influenced by the total number of nodes removed.
Selective extended lymphadenectomy (D2 plus) may have a role in the subgroup of patients who have risk of increased metastasis to those specific nodes. These nodes are defined by two indices - METASTATIC RATE and the THERAPEUTIC INDEX. This talk looks at the current status of gastric cancer in India and our centre’s experience in the management of this cancer. We discuss the rationale and role of a D2 plus lymphadenectomy in advanced gastric cancer.
One needs to remember that in gastric cancer - it is not only what you take out, but also what you leave behind, that defines survival.