The extent of lymph node dissection for gastric cancer: a critical appraisal.
The extent of lymphadenectomy during therapeutic gastrectomy for gastric cancer remains a protracted and controversial issue. While traditionally extended lymphadenectomy is performed in Eastern Asia, limited lymphadenectomy is advocated by most western surgeons. Two large western randomized trials, meta-analyses and a recent systematic review were unable to demonstrate overall benefit from extended lymphadenectomy. In this review, the currently available data on this topic are critically evaluated, while ongoing studies and future perspective are discussed.
de Bree
Eelco
E
Department of Surgical Oncology, Medical School of Crete University Hospital, Heraklion, Greece. debree@edu.uoc.gr
Charalampakis
Vasilis
V
Melissas
John
J
Tsiftsis
Dimitris D
DD
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D001208:Asia; D017024:Chemotherapy, Adjuvant; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery