Research on the Impact of Different Lymph Node Dissection Scopes on Postoperative Recurrence and Survival Rates in Patients with Early Gastric Cancer

Abstract

Objective: To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer, providing evidence-based support for optimizing clinical surgical plans. Methods: A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023. Patients were divided into Group D1 (n = 50) and Group D2 (n =50) based on the extent of lymph node dissection. Group D1 underwent limited lymph node dissection (dissection of the first station of lymph nodes around the stomach), while Group D2 underwent standard lymph node dissection (dissection of the first and second stations of lymph nodes around the stomach). Surgical-related indicators, the incidence of postoperative complications, the 2-year recurrence rate, and the 2-year survival rate were compared between the two groups of patients. Results: The operative time, intraoperative blood loss, postoperative hospital stay, and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group (all P < 0.001). The overall incidence of postoperative complications was higher in the D1 group than in the D2 group, but the difference was not statistically significant (χ² = 0.884, P = 0.766). After a 2-year follow-up, the recurrence rate was significantly higher in the D1 group than in the D2 group (χ² = 4.000, P = 0.046). The 2-year survival rate was significantly lower in the D1 group than in the D2 group (χ² = 5.005, P = 0.025). A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion, degree of differentiation, and lymph node metastasis status, and the recurrence rates of different subgroups were compared. The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage (χ² = 5.005, P = 0.025), higher in poorly differentiated patients than in moderately and well-differentiated patients (χ² = 4.155, P = 0.042), and higher in patients with lymph node metastasis than in those without lymph node metastasis (χ² = 4.512, P = 0.034). Conclusion: Compared with D1 limited lymph node dissection, D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications. Although the surgical trauma is slightly greater, the overall prognosis is better, making it a preferred surgical treatment option for patients with early-stage gastric cancer.