Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.12883
Revised: March 4, 2014
Accepted: April 15, 2014
Published online: September 28, 2014
Core tip: The extension of lymphadenectomy in advanced gastric cancer has been debated for several decades. Till recently Western surgeons supported limited lymphadenectomy in agreement with a Cochrane review and several meta-analyses, while Japanese surgeons preferred the extended procedure. Nowadays extended lymphadenectomy is considered the procedure of choice by most national guidelines. In gastric cancer surgery evidence-based medicine (EBM) is lagging behind national guidelines, rather than preceding and orienting them. To eliminate this lag, EBM should value to a larger extent Eastern Asian literature and should evaluate not only the quality of the study design but also the quality of surgical procedures.