Subtotal gastrectomy with conventional D2 lymphadenectomy for carcinoma of the distal gastric portion: A retrospective cohort study on clinical outcomes

• Results in 228 patients with distal gastric carcinoma were delineated.
• Patients underwent surgery in 2005–2007.
• The overall cumulative 1-year survival rate was 83.8%.
• The overall cumulative 5-year survival rate was 54.4%.
• Probability of cumulative 5-year survival decreases five times when N ratio is > 0.25.

BackgroundThe study was aimed to delineate the postoperative morbidity, mortality and long-term follow-up results after R0 subtotal gastrectomy with D2 lymphadenectomy for invasive non-disseminated adenocarcinoma of the distal gastric portion.MethodsBetween January 2005 and December 2007, 228 patients with median age at hospitalisation 66.6 ± 11.4 years underwent the above mentioned surgery for histologically proven distal gastric adenocarcinoma.ResultsPostoperative morbidity was documented in 92 (40.4%) of patients within 30 days. An anastomotic leakage was diagnosed in two (0.9%), peritonitis in two (0.9%), anastomositis in five (2.2%), and prolonged ileus in six (2.6%) patients. Nine patients died (3.9%). The overall 1-year survival rate was 83.8%, and the 5-year survival rate was 54.4%. Gender, age, TNM stage, pN, and N ratio were independent factors predicting a long-term prognosis for patients.ConclusionsA R0 type distal subtotal gastrectomy with standard D2 lymphadenectomy for a histologically proven invasive adenocarcinoma of the distal gastric portion without distant metastasis offers acceptable postoperative morbidity and mortality, and considerably high overall cumulative 5-year survival rate. The probability of cumulative survival decreases five times when the ratio between metastatic and examined lymph nodes is > 0.25.