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Current standards of lymphadenectomy in gastric cancer

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Abstract

Gastric cancer remains the 5th most common cancer and the 3rd most common cause of cancer mortality. Most patients diagnosed with gastric cancer still have a poor prognosis due to its advanced presentation at diagnosis, even in countries with developed screening programs. Surgery is the cornerstone of the treatment for gastric cancer, often combined with perioperative chemotherapy. Lymph node dissection is a crucial component of the surgical treatment of gastric cancer. D1 lymphadenectomy is currently recommended for early stage tumors. The extent of lymphadenectomy in advanced gastric cancer, however, is still a matter of debate between Eastern and Western surgeons. Although a D2 dissection is the current standard recommended by most guidelines, there might be a place for more limited dissections such as D1 + in selected cases. This evidence-based review will help defining the optimal lymphadenectomy for patients with gastric cancer.

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Acknowledgements

Dr. Agustin Valinoti for his artwork on the figure showing gastric lymph node stations.

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Authors and Affiliations

  1. Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina

    Manuela Monrabal Lezama, Nicholas S. Murdoch Duncan, Sofia Bertona & Francisco Schlottmann

  2. Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA

    Francisco Schlottmann

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  1. Manuela Monrabal Lezama
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  2. Nicholas S. Murdoch Duncan
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  3. Sofia Bertona
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  4. Francisco Schlottmann
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All authors contributed on data collection, study design, data analysis and writing.

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Correspondence to Francisco Schlottmann.

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Manuela Monrabal Lezama, Nicholas S. Murdoch Duncan, Sofia Bertona, and Francisco Schlottmann have no conflicts of interest/Competing interest to disclose.

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Monrabal Lezama, M., Murdoch Duncan, N.S., Bertona, S. et al. Current standards of lymphadenectomy in gastric cancer. Updates Surg 75, 1751–1758 (2023). https://doi.org/10.1007/s13304-023-01576-7

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