Surgical care quality and oncologic outcome after D2 gastrectomy for XXXX .

@entity1 @entity5 @entity834 @entity356
AIM: To examine the quality of surgical care and long-term oncologic outcome after D2 gastrectomy for @entity356 . METHODS: From 1999 to 2008, a total of 109 consecutive @entity1 underwent D2 gastrectomy without routine pancreaticosplenectomy in a multimodal setting at our institution. Oncologic outcomes together with clinical and histopathologic data were analyzed in relation to the type of surgery performed. Staging was carried out according to the Union for International @entity5 Control criteria of 2002. @entity1 were followed-up for five years at the outpatient clinic. The primary measure of outcome was long-term survival with the quality of surgery as a secondary outcome measure. Clinical data were retrospectively collected from the @entity1 records, and causes of death were obtained from national registries. RESULTS: A total of 109 @entity1 (58 @entity1 ) with a mean age of 67.4    11.2 years underwent total gastrectomy or gastric resection with D2 lymph node dissection. The @entity5 stage distribution was as follows: stage   I, (27/109) 24.8%; stage II, (31/109) 28.4%; stage III, (41/109) 37.6%; and stage IV, (10/109) 9.2%. Forty @entity1 (36.7%) received chemotherapy or chemoradiotherapy. The five-year overall survival rate for all 109 @entity1 was 45.0%, and was 47.1% for the 104 @entity1 treated with curative R0 resection. The five-year disease-specific survival rates were 53.0% and 55.8%, respectively. In a multivariate analysis, body mass index and @entity5 stage were independent prognostic factors for overall survival (both P < 0.01), whereas body mass index, @entity5 stage, @entity5 site, Lauren classification, and lymph node invasion were prognostic factors for @entity5 -specific survival (all P < 0.05). Postoperative 30-d mortality was 1.8% and 30-d, surgical (including three @entity834 , two of which were treated conservatively), and general morbidities were 26.6%, 12.8%, and 14.7%, respectively. CONCLUSION: D2 dissection is a safe surgical option for @entity356 , providing quality surgical care and long-term oncologic outcomes that are in line with current Western standards.
