D2 Lymphadenectomy Alone or with Para-aortic Nodal Dissection for Gastric Cancer

This randomized trial of the surgical treatment of curable gastric cancer in Japan compared gastrectomy and extended (D2) lymphadenectomy with gastrectomy and D2 lymphadenectomy plus para-aortic nodal dissection (PAND). There were no significant differences in overall survival between the two groups. Gastrectomy with D2 lymphadenectomy remains the preferred surgical treatment for curable gastric cancer in Japan. This trial in Japan compared gastrectomy and extended (D2) lymphadenectomy with gastrectomy and D2 lymphadenectomy plus para-aortic nodal dissection (PAND). There were no significant differences in overall survival between the two groups. Gastric cancer is the second leading cause of cancer death worldwide, although its incidence is decreasing. 1 About 60% of new cases of gastric cancer occur in eastern Asia; the incidence of new cases in Japan is 100,000 per year. Chemotherapy helps to prolong survival in cases of advanced disease, but surgical resection is the most effective treatment for curable gastric cancer. Reports from the Gastric Cancer Registry and other retrospective studies 2 – 4 have made radical gastrectomy with extended (D2) removal of regional lymph nodes the standard for the treatment of curable gastric cancer in Japan. Two randomized, controlled European trials . . .