Este documento resume los hallazgos de varios estudios sobre la linfadenectomía D2 para el cáncer gástrico. Algunos estudios tempranos mostraron una mayor morbilidad y mortalidad con D2, pero estudios más recientes sugieren que D2 podría mejorar la supervivencia en etapas intermedias cuando es realizada por cirujanos experimentados. Se necesitan más estudios controlados para evaluar completamente los beneficios potenciales de D2.

1. LINFADENECTOMÍA D2 EN EL CANCER GÁSTRICO. Fundamentos Científicos y Técnicos. Dr. Ruiz Luque Febrero 2008

4. CONCLUSIONS: D2 dissection carries increased mortality risks associated with spleen and pancreas resection, and probably with inexperience and low case volumes. Randomised studies show no evidence of overall survival benefit, but possible benefit in T3+ tumours. These results may be confounded by surgical learning curves and poor surgeon compliance. Non-randomised comparisons suggest a possible survival benefit for D2 in intermediate UICC stages (II y IIIa). Observational studies show high 5 year survival and low operative mortality after D2 dissection in experienced units, and poor results after D1 dissection in non-specialist units. Further studies, with precautions to eliminate learning curve effects, contamination and non-compliance, are needed to evaluate D2 dissection in intermediate stage gastric cancer.

23. Revisiones y Guías Clínicas

24. Revisiones y Guías Clínicas Lymphadenectomy B - D2 lymphadenectomy, with a minimum of 25 lymph nodes removed, considered for patients undergoing gastrectomy. Routine resection of additional organs (spleen and pancreas) during gastrectomy is not recommended.

25. Revisiones y Guías Clínicas