[Lymphodissection in the treatment of early stomach cancer: D1 or D2?]

The study was designed to analyse results of D1- and D2-lymphodissection in 394 patients with early stomach cancer between 1990-2007. Risk factors of lymphogenic metastasis (lymphatic invasion, submucous invasion, tumour size in excess of 4 cm, venous invasion, tumour spread to the oesophagus, type 0I and 0II tumors, poor differentiation) are considered to be an absolute indication for D2-lymphodissection that allows to significantly reduce the frequency of relapses and improve the outcome of surgery. The restriction of surgery volume to D1-lymphodissection is possible only in patients with negligibly low risk of metastasis regardless of the type of early cancer.