Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal

DOI: 10.2122/gbc.2008.0095


D2 vs. D4 lymphadenectomy for gastric cancer

Maurizio Degiuli M.D.

Affiliation: Ospedale San Giovanni Battista di Torino- Presidio SGAS-Sc Chirurgia Generale, 10-Turin, Italy


Over the last three decades extend of lymphadenectomy for resectable gastric cancer has been controversial. D2 lymphadenectomy has been the standard surgery for nonmetastatic gastric cancer in Japan .
However, in the West in an absence of evidence from randomized controlled trials (RCT), D2 surgery has not been the standard approach.
Recently, Sasako et al [1] published in the NEJM the results of a Japanese RCT comparing D2 lymphadenectomy alone or D2 plus para-aortic lymph nodal dissection (PAND, for advanced stages II/III gastric cancer.
Here, these data are analyzed . What are the clinical implications of this study in the USA and Europe ?

Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

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last update: 3 February 2004