ABSTRACT  

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 ?