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Gastrointestinal Diseases

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Stomach Cancer

Operable gastric cancer was treated by radical gastrectomy and limited D1 lymphadenectomy

Operable gastric cancer was treated by radical gastrectomy and extended D2 lymphadenectomy

Radical gastrectomy with D1 lymphadenectomy

D1 lymphadenectomy

Radical gastrectomy with D2 lymphadenectomy

D2 lymphadenectomy

Gastric carcinoma is the second most common cause of cancer-related deaths and its main treatment modality if potentially curable is surgery but the optimal surgical resection is controversial. The aim of the current study was to assess the outcomes of curative D2 compared to D1 gastrectomy of operable gastric carcinoma regarding postoperative morbidity and mortality, disease recurrence and survival rates.

80 consecutive patients with potentially operable gastric carcinoma were randomized via concealed envelopes into 2 groups (each included 40 patients), group I managed by radical gastrectomy with D1 lymphadenectomy while group II managed by radical gastrectomy with D2 lymphadenectomy . Both groups were compared regarding postoperative mortality, morbidities, tumor recurrence and 2 years survival rates.

Curative D2 vs D1 Lymphadenectomy in Operable Gastric Carcinoma

Surgical and Oncologic Outcomes After Curative D2 vs D1 Gastrectomy in Operable Gastric Carcinoma, A Randomized Controlled Study in Egyptian Population

Frequency of early postoperative complications

Frequency of early postoperative mortality

Frequency of tumor recurrence within 2 years after curative surgery

Frequency of patients died because of gastric cancer within 2 years after curative surgery

Percentage of patients survived for 2 years without tumor recurrence

Percentage of patients survived for 2 years with/without tumor recurrence

University of Alexandria

Ass. Professor

Patients are managed by radical gastrectomy with D1 lymphadenectomy

Patients are managed by radical gastrectomy with D2 lymphadenectomy

Mohamed Elmessiry, MD

Surgery is the mainstay treatment of operable gastric carcinoma but the optimal extent of lymph node (LN) dissection is controversial. The aim of this observational study is to assess the outcomes after curative D2 compared to D1 gastrectomy of operable gastric carcinoma regarding operative and long term oncological outcomes.

This observational study included 80 consecutive patients presented by operable gastric cancer treated by D2 gastrectomy at Alexandria University hospital between January 2010 and January 2016, (Group I). Another 68 consecutive patients presented by operable gastric cancer treated by D1 gastrectomy earlier during the same period were included as a control (Group II). All patients had undergone preoperative gastroscopy and biopsy, chest and abdomen computed tomography (CT). All surgeries were performed by surgeons experienced in both D1 and D2 dissection and a standardized protocol for D1 and D2 gastrectomy was followed in all patients. The type of gastrectomy (distal or total) was done according to the site of the tumor; distal gastrectomy was done if there is a free safety margin of 4 cm beyond the proximal resection line otherwise total gastrectomy was done. Resection of the spleen and/or pancreatic tail were done if directly invaded by the primary tumor or metastatic LN. Patients with p T2 or greater, or with positive LN received adjuvant chemotherapy. Follow up was done as outpatient visits for average 5 years. Both groups were compared regarding postoperative morbidity and mortality, disease recurrence and survival rates.

D2 Versus D1 Gastrectomy of Operable Gastric Cancer

Operative and Long Term Oncological Outcomes After D2 Versus D1 Gastrectomy of Operable Gastric Cancer

Frequency of tumor recurrence within 5 years after curative surgery

Frequency of Cancer specific mortality within 5 years after curative surgery

Percentage of patients survived for 5 years after surgery without tumor recurrence

Percentage of patients survived for 5 years after surgery with/without tumor recurrence

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Curative D2 vs D1 Lymphadenectomy in Operable Gastric Carcinoma	NCT04340440	Gastric Cancer	D1 lymphadenect... D2 lymphadenect...	20 Years - 70 Years	University of Alexandria
Curative D2 vs D1 Lymphadenectomy in Operable Gastric Carcinoma	NCT04340440	Gastric Cancer	D1 lymphadenect... D2 lymphadenect...	20 Years - 70 Years	University of Alexandria
D2 Versus D1 Gastrectomy of Operable Gastric Cancer	NCT04429841	Gastric Cancer	Radical gastrec... Radical gastrec...	20 Years - 80 Years	Alexandria University

Spots Global Cancer Trial Database for operable gastric cancer