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Body Mass Index Does Not Affect Systematic D2 Lymph Node Dissection and Postoperative Morbidity in Gastric Cancer Patients

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Abstract

Background: The extent of standard lymph node dissection (D1, D2, or D3) in gastric cancer patients is still controversial. Several prospective European trials attained contradictory results. A generally increased body mass index (BMI) of the European patients was assumed to be one of the major causes for postoperative morbidity.

Methods: We evaluated the effect of BMI on the quality of routine D2 lymph node dissection and on postoperative morbidity in patients with gastric cancer who underwent a potentially curative total gastrectomy. A total of 199 consecutive gastric cancer patients who underwent a total gastrectomy and a routine D2 lymph node dissection between 1992 and 2001 were included in the study. According to BMI, they were assigned to three groups: group A, with BMI <25 kg/m2 (normal body weight); group B, with BMI of 25 to 30 kg/m2 (overweight); and group C, with BMI >30 kg/m2 (obesity). Parameters such as complete histopathological staging, intraoperative blood loss, length of operation, and surgical and nonsurgical morbidity were recorded and correlated within the different groups.

Results: No significant differences were found with regard to the number of examined lymph nodes, blood loss, length of operation, surgical complications, or length of stay in the intensive care unit.

Conclusions:In contrast to comparable Japanese studies, our analysis reveals that even for overweight patients, a standard D2 lymph node dissection is justified without significantly increased morbidity.

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Authors and Affiliations

  1. Department of Surgery and Surgical Oncology, Humboldt University, Charité, Campus Berlin Buch, Robert-Rössle Hospital, HELIOS Klinikum, Berlin, Germany

    Stephan Gretschel MD, Frank Christoph MD, Andreas Bembenek MD, Lope Estevez-Schwarz MD & Peter M. Schlag MD, PhD

  2. Pathology Unit, Humboldt University, Charité, Campus Berlin Buch, Robert-Rössle Hospital, HELIOS Klinikum, Berlin, Germany

    Ulrike Schneider MD

  3. Department of Surgery and Surgical Oncology, University Hospital Charité, Campus Buch, Humboldt University to Berlin, Robert-Rössle Klinik at the HELIOS Klinikum Berlin, Lindenberger Weg 80, 13125, Berlin, Germany

    Peter M. Schlag MD, PhD

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  1. Stephan Gretschel MD
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  2. Frank Christoph MD
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  3. Andreas Bembenek MD
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Correspondence to Peter M. Schlag MD, PhD.

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Gretschel, S., Christoph, F., Bembenek, A. et al. Body Mass Index Does Not Affect Systematic D2 Lymph Node Dissection and Postoperative Morbidity in Gastric Cancer Patients. Ann Surg Oncol 10, 363–368 (2003). https://doi.org/10.1245/ASO.2003.07.011

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  • DOI: https://doi.org/10.1245/ASO.2003.07.011

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