Published online Apr 27, 2016. doi: 10.4240/wjgs.v8.i4.294
Peer-review started: October 2, 2015
First decision: November 4, 2015
Revised: December 25, 2015
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: April 27, 2016
Processing time: 204 Days and 3.2 Hours
The stomach is the sixth most common cause of cancer worldwide. Surgery is an important component of the multi-modality treatment of the gastric cancer. The extent of lymphadenectomy has been a controversial issue in the surgical management of gastric cancer. The East-Asian surgeons believe that quality-controlled extended lymphadenectomy resulting in better loco-regional control leads to survival benefit in the gastric cancer; contrary to that, many western surgeons believe that extended lymphadenectomy adds to only postoperative morbidity and mortality without significantly enhancing the overall survival. We present a comprehensive review of the lymphadenectomy in the gastric cancer based on the previously published randomized controlled trials.
Core tip: The only potentially curative option for the gastric cancer is surgery which may promise complete resection. Presently, D2 lymphadenectomy is the standard of care in an operable gastric cancer. Routine excision of spleen and pancreatic tail should not be undertaken as it increases the postoperative morbidity without adding significantly to overall survival.