Yarema R, de Manzoni G, Fetsych T, Ohorchak M, Pliatsko M, Bencivenga M. On the road to standardization of D2 lymph node dissection in a European population of patients with gastric cancer. World J Gastrointest Oncol 2016; 8(6): 489-497 [PMID: 27326318 DOI: 10.4251/wjgo.v8.i6.489]
Corresponding Author of This Article
Roman Yarema, MD, PhD, Department of Oncology and Medical Radiology, Lviv National Medical University named after Danylo Halytskyi, Pekarska str., 69, 79010 Lviv, Ukraine. yaremarom@rambler.ru
Research Domain of This Article
Oncology
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2016; 8(6): 489-497 Published online Jun 15, 2016. doi: 10.4251/wjgo.v8.i6.489
On the road to standardization of D2 lymph node dissection in a European population of patients with gastric cancer
Roman Yarema, Giovanni de Manzoni, Taras Fetsych, Myron Ohorchak, Mykhailo Pliatsko, Maria Bencivenga
Roman Yarema, Taras Fetsych, Department of Oncology and Medical Radiology, Lviv National Medical University named after Danylo Halytskyi, 79010 Lviv, Ukraine
Giovanni de Manzoni, Maria Bencivenga, Department of Surgery, General and Upper G.I. Surgery Division, University of Verona, 37126 Verona, Italy
Myron Ohorchak, Department of Abdominal Surgery, Lviv Regional State Cancer Diagnostic and Therapeutic Center, 79000 Lviv, Ukraine
Mykhailo Pliatsko, Department of Endoscopic, Lviv Regional Clinical Diagnostic Center, 79010 Lviv, Ukraine
Author contributions: Yarema R performed the research and wrote the paper; de Manzoni G, Fetsych T, Ohorchak M, Pliatsko M and Bencivenga M contributed critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roman Yarema, MD, PhD, Department of Oncology and Medical Radiology, Lviv National Medical University named after Danylo Halytskyi, Pekarska str., 69, 79010 Lviv, Ukraine. yaremarom@rambler.ru
Telephone: +38-67-9406933 Fax: +38-32-2757632
Received: January 15, 2016 Peer-review started: January 18, 2016 First decision: February 22, 2016 Revised: March 24, 2016 Accepted: April 14, 2016 Article in press: April 18, 2016 Published online: June 15, 2016 Processing time: 138 Days and 2.7 Hours
Abstract
The amount of lymph node dissection (LD) required during surgical treatment of gastric cancer surgery has been quite controversial. In the 1970s and 1980s, Japanese surgeons developed a doctrine of aggressive preventive gastric cancer surgery that was based on extended (D2) LD volumes. The West has relatively lower incidence rates of gastric cancer, and in Europe and the United States the most common LD volume was D0-1. This eventually caused a scientific conflict between the Eastern and Western schools of surgical thought: Japanese surgeons determinedly used D2 LD in surgical practice, whereas European surgeons insisted on repetitive clinical trials in the European patient population. Today, however, one can observe the results of this complex evolution of views. The D2 LD is regarded as an unambiguous standard of gastric cancer surgical treatment in specialized European centers. Such a consensus of the Eastern and Western surgical schools became possible due to the longstanding scientific and practical search for methods that would help improve the results of gastric cancer surgeries using evidence-based medicine. Today, we can claim that D2 LD could improve the prognosis in European populations of patients with gastric cancer, but only when the surgical quality of LD execution is adequate.
Core tip: The amount of lymph node dissection required during surgical treatment of gastric cancer has been quite controversial. We can now claim that D2 lymph node dissection improves the prognosis in European populations with gastric cancer, but only when the surgical quality of the lymph node dissection execution is adequate.
