title: An evidence-based medicine review of lymphadenectomy extent for gastric cancer.
abstract: BACKGROUND
  Several studies in the literature have investigated the possible role of the extent of lymphadenectomy in gastric cancer treatment failure. The current study attempted to determine the effectiveness and safety of lymphadenectomy with gastrectomy for the treatment of gastric cancer.
  
  
  METHODS
  Randomized controlled trials (RCTs) were identified by means of MEDLINE, EMBASE, Cochrane Controlled Trials Register databases, and Chinese Biomedical Database, as well as by selecting references from relevant articles.
  
  
  RESULTS
  Overall, 14 RCTs (3,432 patients) were included in the meta-analysis. Of the D1 and D2 surgery groups, the operative mortality and postoperative morbidity were higher in the D2 group than in the D1 group, but the 3- and 5-year survival rates were not statistically different. Also the operative time was shorter in D1 compared to D2. In the D2 versus the D3 surgical group, the operative mortality, percentage of postoperative complications, operative time, and hospital stay were not significantly different.
  
  
  CONCLUSIONS
  The results suggest that D2 and D3 surgery may not offer specific advantages for gastric cancer and instead may lead to disadvantages for patient outcomes.
authors: Department of General Surgery, Lanzhou University Second Hospital, No 80 Cuiyingmen, Chengguan District, Lanzhou City, Gansu, China.
authors: Sun Hu
authors: SH
authors: Yang
authors: You Cheng
authors: YC
authors: Zhang
authors: Ke Hu
authors: KH
authors: Yang
authors: You Ping
authors: YP
authors: Li
authors: Xiao Dong
authors: XD
authors: He
authors: Jin Hui
authors: JH
authors: Tian
authors: Ting Hong
authors: TH
authors: Lv
authors: Ying Hua
authors: YH
authors: Hui
authors: Neel
authors: N
authors: Sharma
mesh_terms: D019317:Evidence-Based Medicine; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome