Survival benefit of extended D2 resection for proximal gastric cancer

Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

“…Curative resection was the determining factor to improve the 5-year survival in this type of tumor [31] . Although D2 radical resection for patients with cancer of gastric cardia and fundus is widely accepted [32] , how many lymph nodes should be removed to accurately predict clinical outcome has not been determined. Barbour et al [33] suggested patients with Siewert types Ⅱ and Ⅲ adenocarcinoma of the GEJ should undergo adequate lymphadenectomy to permit examination of ≥ 15 lymph nodes allowing the accurate identification of prognostic variables.…”

Outcome of Patients With Proximal Gastric Cancer Depends on Extent of Resection and Number of Resected Lymph Nodes

“…Ultimately, high-risk stage I patients become low-risk stage II patients, which leads to the erroneous observation that extended lymphadenectomy enhances the survival of patients with stage I and II gastric cancer. [23][24][25] Proponents of the D2 resection question the design and setting of the two randomized D1/D2 European trials. Since 1962, Japanese surgeons have been performing extensive D2 and D3 resections for gastric cancer with operative mortality rates of less than 3%.…”

Prognostic significance of perinodal extension in gastric cancer

“…Lymph node metastasis is the primary prognostic factor in gastric cancer [1][2][3][4][5] and systematic extensive lymph node dissection has a favorable effect on survival [2,[6][7][8][9][10][11][12][13][14][15][16]. Still now, the extent of nodal involvement and the number of metastasized lymph node are the focus for determining a patient's prognosis.…”