Extended lymph node dissection in gastric carcinoma: where do we stand after the Dutch and British randomized trials?

Abstract

Despite declining incidence in Western Europe 1 Ekstrom A.M. Hansson L.E. Signorello L.B. Lindgren A. Decreasing incidence of both major histologic subtypes of gastric carcinoma—a population-based study in Sweden. Br J Cancer. 2000; 83 : 391-396 Crossref PubMed Scopus (85) Google Scholar and the United States, 2 Hundahl S.A. Menck H.R. Mansour E.G. Winchester D.P. The National Cancer Data Base report on gastric carcinoma. Cancer. 1997; 80 : 2333-2341 Crossref PubMed Scopus (133) Google Scholar gastric carcinoma remains the second most common cause of cancer death worldwide with over 600,000 deaths per year. 3 Pisani P. Parkin D.M. Bray F. Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999; 83 : 18-29 Crossref PubMed Scopus (1402) Google Scholar The curative treatment of gastric carcinoma remains primarily surgical. But developments in surgery have been slowed in the West by the large percentage of patients presenting with advanced cancers. In the meanwhile, some developments have taken place in Japan, 4 Hermanek P. Sobin L.H. UICC TNM Classification of Malignant Tumours. 4th ed. Springer-Verlag, New York 1992 Google Scholar in which early-stage cancers are more frequently encountered, caused in part by nationwide mass screening.