Does the extent of lymph node dissection affect the postoperative survival of patients with gastric cancer and disseminating peritoneal metastasis?

For patients with gastric cancer and either P1 or P2 peritoneal metastasis, no definite consistent policy with respect to the extent of lymph node dissection has yet been established. In palliatively gastrectomized patients, we analyzed the relationship between the extent of lymphadenectomy and postoperative survival. In patients with P1, an R2 or R3 lymphadenectomy was associated with a significantly improved postoperative survival as compared to an R1 dissection, while this, however, was not the case in patients with P2. As this study was not intended to be a prospective randomized study, a definite conclusion should be avoided. However, our findings suggest that in patients with P1, surgery should not be confined to a resection of the primary lesion, but should also include an R2 or R3 lymphadenectomy.