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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 2875-2893
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.2875
Gastric cancer: Current status of lymph node dissection
Maurizio Degiuli, Giovanni De Manzoni, Alberto Di Leo, Domenico D’Ugo, Erica Galasso, Daniele Marrelli, Roberto Petrioli, Karol Polom, Franco Roviello, Francesco Santullo, Mario Morino
Maurizio Degiuli, Erica Galasso, Mario Morino, Department of Surgery, University of Turin, Citta della Salute e della Scienza, 10126 Turin, Italy
Giovanni De Manzoni, Department of Surgery, University of Verona, Ospedale Borgo Trento, 37126 Verona, Italy
Alberto Di Leo, Division of Surgery, Ospedale di Arco, 38062 Arco TN, Italy
Domenico D’Ugo, Francesco Santullo, Department of Surgery, University “Cattolica del Sacro Cuore”, “A.Gemelli” University Hospital, 00168 Rome, Italy
Daniele Marrelli, Franco Roviello, Department of Surgery, University of Siena, 53100 Siena, Italy
Roberto Petrioli, Department of Oncology, University of Siena, 53100 Siena, Italy
Karol Polom, Department of Surgery, Wielkopolskie Centrum Onkologii, 61-866 Poznan, Poland
Author contributions: Degiuli M designed the article structure; Degiuli M, De Manzoni G, Di Leo A, D’Ugo D, Galasso E, Marrelli D, Petrioli R, Roviello F, Santullo F and Morino M. contributed equally to this work and wrote the paper.
Conflict-of-interest statement: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Maurizio Degiuli, MD, Chirurgia Generale Universitaria 1, Department of Surgery, University of Turin, Citta della salute e della scienza, 10126 Turin, Italy.
Telephone: +39-335-8111286 Fax: +39-11-6336725
Received: July 7, 2015
Peer-review started: July 8, 2015
First decision: August 26, 2015
Revised: October 9, 2015
Accepted: January 17, 2016
Article in press: January 18, 2016
Published online: March 14, 2016
Core Tip

Core tip: Recently early gastric cancer and advanced gastric cancer (AGC) has been successfully treated endoscopically; surgery is offered only to patients not fitted for less invasive treatment and in several guidelines D1+ (open, laparoscopic, robotic) is the adequate treatment. For AGC, while D2 gastrectomy is the standard procedure in eastern countries, mostly based on retrospective studies, in the west different randomised controlled trials have been conducted to demonstrate a survival benefit of D2 over D1 with evidence based medicine, with contradictory results. As nowadays D2 gastrectomy can be done safely with pancreas and spleen preservation, it has been suggested also in several western guidelines as the recommended procedure for patients with AGC.