P-261Survival and disease-free survival in a consecutive monocentric series of more than 1000 D-2 gastric resection for cancer

Introduction: D-2 curative gastric resection for cancer without routine distal splenopancreatectomy was not necessarily associated with significantly lower perioperative complications in a series of Western patients observed. Methods: A series of 1011 patients (671 males, 440 females; median age: 64 ± 25 years) consecutive patients with histology-proven gastric cancer was submitted to gastrectomy and extended D-2 lymphadenectomy for treatment of their disease during a 22-year period (1994-2015) at the European Institute of Oncology in Milano, Italy. Caudal pancreas and spleen were routinely preserved, unless the tumor was not closely adjacent to or directly invading these organs. Morbidity, overall per operative mortality, and length of hospital stay were recorded. Results: Five hundred and eighty-six total gastrectomy, and 425 subtotal, were performed. Splenectomy was performed in 16 cases and spleno-pancreatectomy in 24. The postoperative morbidity rate was 16%; the mortality rate was 1.6%. The median length of stay was 11 days. Overall survival and disease-free survival correlated with the number of ablated lymph node, individuating three groups: patients undergone a lymphadenectomy involving 15 nodes or below (group 1) showed a five-year survival of 65 %and adisease-free survival of 60%. Five-year overall survival and disease-free survival was similar among patients undergone a lymphadenectomy of 16 to 25 nodes (group 2) and higher than 25 nodes (group3) was similar, being about 90% and 85% respectively. Conclusion: These results suggested that D-2 gastrectomy with spleen and pancreas routine preservation can be considered a safe treatment of this disease.