Quality control of lymph node dissection in the Dutch Gastric Cancer Trial. BJS 2015; 102: 1388-1393.

Results

Some 1078 patients were included, of whom 711 with potentially curative surgical resections were evaluated. Overall non‐compliance was 80·5 per cent in the D1 and 81·6 per cent in the D2 group. Major non‐compliance occurred in 15·3 per cent of the D1 and 26·0 per cent of the D2 group. Major contamination hardly occurred. Overall 15‐year survival rates in the randomized groups were 21·2 per cent (D1) and 29·0 per cent (D2) (P = 0·351). After exclusion of patients with major non‐compliance and/or major contamination, survival rates were 23·2 per cent (319 patients) and 32·6 per cent (245) respectively (P = 0·261). Where there was major non‐compliance, survival rates in the D1 (58 patients) and D2 (86) groups were 10 and 17 per cent respectively (P = 0·302). Survival in the D2 compliant + contaminated group (139 patients) was significantly better than that in the D1 group without contamination (282): 35·7 versus 19·9 per cent (P = 0·041). In the D2 group, there was a significant difference in survival between contaminated (95 patients) and non‐contaminated (236) groups: 39 versus 25·1 per cent (P = 0·041).