The extended lymphadenectomy in the treatment of gastric cancer

The only potentially curative modality of localized gastric cancer is surgery. However there is area of disagreement among surgeons with respect to the appropriate extent of lymphadenectomy. The retrospective study of a personal experience on 155 patients with gastric cancer; the patients were divided in two groups with respect to the extent of lymphadenectomy. The results of this study highlight the more effectiveness of D2 resection compared with D1 resection with respect to 5th year survival. The goal of treatment is to reduce the risk of recurrent disease. There is considerable debate as to whether the routine use of an extensive en-bloc resection of second echelon lymph nodes (D-2 resection) is superior to a more limited lymphadenectomy of the perigastric lymph nodes (D-1 resection). Therefore the survival benefit of D2 dissection appears to be limited to N2 disease. Since nodal status prediction before or during surgery is inaccurate, all patients with curable disease, including those with N0 or NI disease, should undergone extensive node dissection.