Implication of extended lymph node dissection stratified for advanced gastric cancer
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Updated: Aug 29, 2026
Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Chikara Kunisaki1, Hiroshi Shimada, Masazumi Takahashi
1Second Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. s0714@med.yokohama-cu.ac.jp
Background:
What extent of lymph node dissection for advanced gastric cancer is appropriate is a matter of controversy.
Patients And Methods:
Three hundred and ninety-nine gastric cancer patients underwent potentially curative D2 gastrectomy and 125 underwent D3 gastrectomy between 1985 and 1998.
Results:
Our study revealed that pN3, but not D3 gastrectomy, significantly influenced prognosis. There was no significant difference in the 5-year survival rate and mean survival time between D2 and D3 patients: but the survival in D3 patients with tumor diameters measuring 50-100 mm or with pN1 was significantly longer than that in D2 patients with the same tumors. Analysis of survival of patients with tumor diameters measuring 50-100 mm revealed that there was a significant difference only in pN1. The incidence of lymphatic recurrence was significantly lower in D3 patients with pN1 tumor or a tumor measuring 50-100 mm than in D2 patients.
Conclusion:
Patients with advanced gastric cancer measuring 50-100 mm and pN1 may benefit from para-aortic lymph node dissection.
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