Survival of D1 versus D2 Gastrectomy for Patients with Gastric Cancer in Srinagarind Hospital
Egapong Sathitkarnmanee MD1, Thepakorn Sathitkarnmanee MD2, Vayune Vajanopath MD1
Affiliation : 1 Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Gastric cancer is the second leading cause of cancer death and the fourth most common cancer worldwide. For
patients considered curable, surgery is the main curative treatment. There is controversy regarding extensiveness of lymph node
dissection between D1, limited to the perigastric nodes, and D2, extended to regional lymph nodes outside the perigastric area.
Objective : The objective of the present study was to compare the survival rate of patients that underwent D1 and D2 gastrectomy
at Srinagarind Hospital.
Materials and Methods : The present research was a retrospective cohort study. The inclusion criterion was all resectable gastric
cancer patients that underwent gastrectomy with lymphadenectomy for curative intention at Srinagarind Hospital between January
2010 and December 2014. The primary outcome was the survival rate of patients with D1 and D2 gastrectomy.
Results : Seventy-four eligible patients were included. The overall 5-year and median survival time of all recruited patients in the
present study were 17.4% (95% CI 5.9 to 28.9) and 584 days (95% CI 446 to 722) with comparable survival between D1 and D2
group. There were 10 cases (13.51%) of morbidity such as bile leakage, wound infection, pancreatic (cid:976)istula, upper gastrointestinal
bleeding, and re-operation from postoperative bleeding. There was one case (1.35%) of postoperative mortality. Postoperative
complications and mortality of D1 and D2 group did not differ signi(cid:976)icantly (p=0.20).
Conclusion : No difference was found in the survival and complication between D1 and D2 gastrectomy at Srinagarind Hospital.
Keywords : Gastric cancer, D1 gastrectomy, D2 gastrectomy, Survival, Morbidity, Mortality
